Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 176463 | NY |
NPI | 1033141973 |
---|---|
Provider Name | John W Wayman |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14618-2645 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 17/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000523907002 | COMMUNITY BLUE (01) | NY |
01234073 | (05) | NY |
040017649 | RAIL ROAD MEDICARE (01) | NY |
0600048 | GHI (01) | NY |
5327333 | AETNA (01) | NY |
E75039 | (02) | NY |
G0182467590 | BLUE CHOICE (01) | NY |
MDH268 | PREFERRED CARE (01) | NY |
P010176463 | BLUE SHIELD (01) | NY |