Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 30016716 | OH |
N | 1223G0001X | General Practice | 30016716 | OH |
N | 213EG0000X | General Practice | 30016716 | OH |
NPI | 1316057151 |
---|---|
Provider Name | Mr. Melvin Sylvester Waymire JR. |
First Address | Huber Heights, OH 45424-3240 |
Second Address | Hyber Heights, OH 45424-3240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 19/07/2016 |