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NPI Code Detail

MEDICARE: MICHAEL SCOTT WENZEL M.D., F.A.A.F.P.

MEDICARE:   MICHAEL SCOTT WENZEL  M.D., F.A.A.F.P.
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 Physician1025416MD
2207Q00000XFamily Medicine PhysicianMD039465DC
3207Q00000XFamily Medicine Physician0101057449VA

General Provider Information

NPI Number : 1699776591
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL SCOTT WENZEL M.D., F.A.A.F.P.
Provider Business Mailing Address
First Line : 2101 E JEFFERSON ST
Second Line : KAISER PERMANENTE MEDICARE ENROLLMENT
City : ROCKVILLE
State : MD
Zip : 20852-4908
Country : US
Telephone Number : 301-816-2424
Fax Number :
Provider Business Practice Location Address
First Line : 12255 FAIR LAKES PKWY
Second Line : KAISER PERMANENTE FAIR OAKS MEDICAL CENTER
City : FAIRFAX
State : VA
Zip : 22033-3952
Country : US
Telephone Number : 703-934-5700
Fax Number : 703-934-5835
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 06/13/2021

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