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NPI Code Detail

MEDICARE: HACKER, HOPPLE, GROSSMAN, WENZKE MEDICAL GROUP, INC.

MEDICARE: HACKER, HOPPLE, GROSSMAN, WENZKE MEDICAL GROUP, INC.
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1407106925
Entity Type Code : Organization
Provider Name (Legal Business Name) : HACKER, HOPPLE, GROSSMAN, WENZKE MEDICAL GROUP, INC.
Provider Business Mailing Address
First Line : 4640 W ALEXIS RD
Second Line :
City : TOLEDO
State : OH
Zip : 43623-1182
Country : US
Telephone Number : 419-843-8186
Fax Number : 419-479-2579
Provider Business Practice Location Address
First Line : 4640 W ALEXIS RD
Second Line :
City : TOLEDO
State : OH
Zip : 43623-1182
Country : US
Telephone Number : 419-843-8186
Fax Number : 419-479-2579
Authorized Official
Title or Position : TREASURER
Name : DR. ROBERT E WENZKE
Credential : M.D.
Telephone Number : 419-843-8186
Provider Enumeration Date : 09/12/2012
Last Update Date : 09/12/2012

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Directions to “HACKER, HOPPLE, GROSSMAN, WENZKE MEDICAL GROUP, INC. ” Practice Location

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