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Individual
E. M. BRENDAN WYATT
Active
Individual
E. M. BRENDAN WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20641
AL
207W00000X
Ophthalmology Physician
ME167191
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000002044
—
AL
05
—
009976795
—
AL
01
—
051002044
BLUE CROSS BLUE SHIELD
AL
01
—
051525773
BLUE CROSS BLUE SHIELD
AL
Enumeration date
07/27/2006
Last updated
08/19/2026
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