Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 34006920 | OH |
Y | 207Q00000X | Family Doctor | 34006920 | OH |
N | 207QA0401X | Family Doctor - Addiction Medicine | 34006920 | OH |
N | 208D00000X | General Practice Physician | 34006920 | OH |
NPI | 1902832868 |
---|---|
Provider Name | Wayne Cummings |
First Address | Bellefontaine, OH 43311-2305 |
Second Address | Bellefontaine, OH 43311-2281 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 26/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2127773 | (05) | OH |
H03608 | (02) |