Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 25998 | TN |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 25998 | TN |
NPI | 1285633545 |
---|---|
Provider Name | Dr. David J Wendt |
First Address | Chattanooga, TN 37404-1127 |
Second Address | Chattanooga, TN 37404-1127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 02/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3086380 | (05) | TN |
A03341 | (02) | TN |