Provider Demographics
NPI:1992817688
Name:WENDT, PETER PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:PAUL
Last Name:WENDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-1900
Mailing Address - Country:US
Mailing Address - Phone:406-563-8571
Mailing Address - Fax:406-563-8523
Practice Address - Street 1:305 W PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-1900
Practice Address - Country:US
Practice Address - Phone:406-563-8571
Practice Address - Fax:406-563-8523
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7829207X00000X
WI23298207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery