Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | ME0039082 | FL |
Y | 207PE0004X | Emergency Medical Services | ME0039082 | FL |
NPI | 1013085224 |
---|---|
Provider Name | Dr. Wayne Anthony Rahming |
First Address | High Springs, FL 32643-4303 |
Second Address | High Springs, FL 32643-4303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 29/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
266698 | AVMED (01) | FL |
47520 | BCBS FL (01) | FL |
D55083 | (02) | FL |