Provider Demographics
NPI:1447297049
Name:WENZLIK, ADAM C (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:C
Last Name:WENZLIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 96860
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28296-6860
Mailing Address - Country:US
Mailing Address - Phone:919-220-3333
Mailing Address - Fax:
Practice Address - Street 1:4020 N ROXBORO ST STE 100
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2120
Practice Address - Country:US
Practice Address - Phone:919-220-3333
Practice Address - Fax:919-220-6317
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2003-00427207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1346FOtherBCBS
G95769Medicare UPIN
NC2021746AMedicare ID - Type Unspecified