Wenger, Jodi Kim

Wenger, Jodi Kim is an individual health care provider with primary practice located at 850 Harrison Ave Yacc 5, Boston MA 02118-4001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wenger, Jodi Kim can be contacted via phone (617) 414-4841.

Contact Information

Primary practice address
850 Harrison Ave Yacc 5 Boston MA 02118-4001
Phone: (617) 414-4841
Fax: (617) 414-4547
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 150364 Massachusetts

Profile Details

NPI number 1942212212
LBN Legal business name Wenger, Jodi Kim
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Jul 17th, 2014 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942212212 NPPES
Vermont MEDICAID 1008157
Vermont MEDICAID 30201703
Vermont MEDICAID 110090349A

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