Basic Information
| Provider Information | |||||||||
| NPI: | 1336265347 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WENDELL | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | PRESTON | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 295 MIDLAND PKWY | ||||||||
| Address2: | SUMMERVILLE MEDICAL CENTER- EMERGENCY DEPARTMENT | ||||||||
| City: | SUMMERVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294858104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8438325000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 295 MIDLAND PKWY | ||||||||
| Address2: | SUMMERVILLE MEDICAL CENTER- EMERGENCY DEPARTMENT | ||||||||
| City: | SUMMERVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294858104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8438325000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 08/26/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 28191 | SC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.