Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 30355 | NC |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 30355 | NC |
NPI | 1295782753 |
---|---|
Provider Name | Dr. Wayne Andrew Hale |
First Address | Greensboro, NC 27401-1004 |
Second Address | Greensboro, NC 27401-1007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 05/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
24818 | MEDCOST (01) | NC |
38276 | BCBS NC (01) | NC |
5184053 | AETNA (01) | NC |
8938276 | (05) | NC |
9074 | PARTNERS MEDICARE CHOICE (01) | NC |
C84271 | (02) |