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General NPI Number Information
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NPI Number | 1679663959
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Entity Type | Individual
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Provider Name | GLENDA C WRENSFORD M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/15/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | USAMEDDAC WUERZBURG UNIT 26610 ATTN: CREDENTIALS OFFICE
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City | APO
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State | AE
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Zip | 09244
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Country | US
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Telephone | 011499318043932
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Fax |
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Provider Business Mailing Address
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Address Line | USAMEDDAC WUERZBURG UNIT 26610 ATTN: CREDENTIALS OFFICE
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City | APO
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State | AE
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Zip | 09244
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Country | US
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Telephone |
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD 13939
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License Number State | HI
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