Provider Demographics
NPI:1588156947
Name:WENDT, ERIN DWYER (MD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:DWYER
Last Name:WENDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ERIN
Other - Middle Name:PATRICIA
Other - Last Name:DWYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PSC 78 PO BOX 6659
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96326-0067
Mailing Address - Country:US
Mailing Address - Phone:315-225-7740
Mailing Address - Fax:
Practice Address - Street 1:374 MDG
Practice Address - Street 2:BUILDING 5071
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96328
Practice Address - Country:US
Practice Address - Phone:315-225-7740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE32181207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine