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NPI Code Detail

MEDICARE: DR. JOHN C WENDT MD

MEDICARE: DR. JOHN C WENDT MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianR6N16MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386601128
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN C WENDT MD
Provider Business Mailing Address
First Line : 1520 WENTZVILLE PKWY
Second Line :
City : WENTZVILLE
State : MO
Zip : 63385-3408
Country : US
Telephone Number : 636-497-4000
Fax Number :
Provider Business Practice Location Address
First Line : 1520 WENTZVILLE PKWY
Second Line :
City : WENTZVILLE
State : MO
Zip : 63385-3408
Country : US
Telephone Number : 636-497-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 10/14/2021

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Directions to “ DR. JOHN C WENDT MD” Practice Location

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