MEDICARE: DR. ROBERT E. WENGER M.D.

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
1	2084P0800X	Psychiatry Physician	MD016115E	PA

General Provider Information

NPI Number	:	1912007675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT E. WENGER M.D.

Provider Business Mailing Address
First Line	:	811 ALENE RD
Second Line	:
City	:	AMBLER
State	:	PA
Zip	:	19002-2607
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	LIFE OF PURPOSE
Second Line	:	1035 VIRGINIA DRIVE, SUITE 120
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-1903
Country	:	US
Telephone Number	:	267-419-7710
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	03/29/2019

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