Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 9904 | NV |
Y | 213ES0103X | Foot & Ankle Surgery | 9904 | NV |
NPI | 1245371392 |
---|---|
Provider Name | Dr. Wayne Adam Dunetz |
First Address | Las Vegas, NV 89173-1327 |
Second Address | Las Vegas, NV 89148-7624 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2007 |
Last Update Date | 11/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002402377 | (05) | NV |