Poulsen, Wendell T
Poulsen, Wendell T is an individual health care provider with primary practice located at 5659 Parkway Dr Ste 100, Gloucester VA 23061-3792. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Poulsen, Wendell T can be contacted via phone (804) 210-1005.Contact Information
Primary practice address
5659 Parkway Dr Ste 100
Gloucester VA 23061-3792
Phone: (804) 210-1005
Fax: (804) 210-1009
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0101031371 | Virginia |
Profile Details
| NPI number | 1457326811 |
|---|---|
| LBN Legal business name | Poulsen, Wendell T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2006 |
| Last updated | Jan 11th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457326811 | NPPES |
| Virginia | MEDICAID | 010156041 |
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