Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. WENDELL E PETTY, M.D.
ActiveDR. WENDELL E PETTY, M.D. is a Allergy & Immunology healthcare provider located in IDAHO FALLS, Idaho. NPI 1457312308 is currently active in the NPPES registry. Verify at CMS.
Allergy & Immunology · IDAHO FALLS, ID
Registration Details
- NPI Number
- 1457312308
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 30, 2006 (20.398103777163 yrs)
- Last Updated
- Jun 21, 2019
- License
-
MD-2580 (ID)
Practice Information
- Address
-
3422 S 15TH EIDAHO FALLS, ID, 834048262Browse ID providers · Browse ZIP 83404
- Phone
- 2085299292
- Fax
- 2085256013
- Primary Specialty
-
Allergy & Immunology
207K00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.