Basic Information
Provider Information | |||||||||
NPI: | 1619102944 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | WENDLING | ||||||||
FirstName: | SARAH | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | STRIGEN | ||||||||
OtherFirstName: | SARAH | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | MD | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 3200 PLEASANT VALLEY RD | ||||||||
Address2: |   | ||||||||
City: | WEST BEND | ||||||||
State: | WI | ||||||||
PostalCode: | 530959274 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2628367300 | ||||||||
FaxNumber: | 2628367301 | ||||||||
Practice Location | |||||||||
Address1: | 3200 PLEASANT VALLEY RD | ||||||||
Address2: |   | ||||||||
City: | WEST BEND | ||||||||
State: | WI | ||||||||
PostalCode: | 530959274 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2628367300 | ||||||||
FaxNumber: | 2628367301 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/15/2009 | ||||||||
LastUpdateDate: | 06/21/2019 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 35120034 | OH | N |   | Allopathic & Osteopathic Physicians | Anesthesiology |   | 207L00000X | 65288 | WI | Y |   | Allopathic & Osteopathic Physicians | Anesthesiology |   |
No ID Information.