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General NPI Number Information
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NPI Number | 1144472887
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Entity Type | Organization
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Legal Business Name | DR WENDY KLOESZ, M.D., P.A
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 5701 KENWOOD AVE
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City | BALTIMORE
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State | MD
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Zip | 21206-1423
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Country | US
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Telephone | 443-797-3152
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Fax | 410-665-1106
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Provider Business Mailing Address
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Address Line | 5701 KENWOOD AVE
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City | BALTIMORE
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State | MD
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Zip | 21206-1423
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Country | US
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Telephone | 443-797-3152
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WENDY DOROTHY KLOESZ
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Credential | MD
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Telephone | 443-797-3152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D31295
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License Number State | MD
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