Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | ME48572 | FL |
NPI | 1033293824 |
---|---|
Provider Name | Dr. Wayne Swartley Maxson |
First Address | Margate, FL 33063-5755 |
Second Address | Margate, FL 33063-5755 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 17/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C36463 | (02) | FL |