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General NPI Number Information
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NPI Number | 1386698231
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Entity Type | Individual
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Provider Name | WENDY LIANA VANDEMARK MD
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Gender | Female
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32610-2577
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Country | US
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Telephone | 352-265-7981
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Fax |
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Provider Business Mailing Address
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Address Line | 2109 N PATTERSON ST STE B
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City | VALDOSTA
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State | GA
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Zip | 31602-2577
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Country | US
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Telephone | 229-232-4833
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Fax | 877-343-0538
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 30685
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME169013
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 29113
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301075774
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 64010
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 57511
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License Number State | GA
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