Healthcare Provider Details

I. General information

NPI: 1699235192
Provider Name (Legal Business Name): TODD W WECHTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 TATE SPRINGS RD
LYNCHBURG VA
24501-1111
US

IV. Provider business mailing address

2007 TATE SPRINGS RD
LYNCHBURG VA
24501-1111
US

V. Phone/Fax

Practice location:
  • Phone: 434-947-5321
  • Fax: 434-947-5324
Mailing address:
  • Phone: 434-947-5321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number0101283625
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: