Basic Information
| Provider Information | |||||||||
| NPI: | 1447631361 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WENDAHL | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 INDIANA ST STE 320 | ||||||||
| Address2: | |||||||||
| City: | GOLDEN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804015033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034693182 | ||||||||
| FaxNumber: | 3034694693 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 INDIANA ST STE 320 | ||||||||
| Address2: | |||||||||
| City: | GOLDEN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804015033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034693182 | ||||||||
| FaxNumber: | 3034694693 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2015 | ||||||||
| LastUpdateDate: | 07/27/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | DR.0064245 | CO | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.