Basic Information
| Provider Information | |||||||||
| NPI: | 1861650772 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WENGER | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3421 CONCORD RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174029001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178512441 | ||||||||
| FaxNumber: | 7172603322 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 MONUMENT RD | ||||||||
| Address2: | SUITE 1100 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174035024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178512441 | ||||||||
| FaxNumber: | 7172603322 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2008 | ||||||||
| LastUpdateDate: | 09/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MB08767400 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | OS014629 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | FW1233953 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | OS014629 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 1022688500003 | 05 | PA | MEDICAID |