Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | A16930 | CA |
N | 207XS0106X | Orthopaedic Hand Surgeon | A16930 | CA |
NPI | 1306166376 |
---|---|
Provider Name | Dr. Samuel Milton Wayne |
First Address | Monterey, CA 93940-6627 |
Second Address | Monterey, CA 93940-6627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2010 |
Last Update Date | 01/06/2010 |