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Individual
DR. WAYNE NICHOLAS EVANCHO
Active
Individual
DR. WAYNE NICHOLAS EVANCHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS5535
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06365500
—
FL
01
—
1214206
CIGNA
FL
01
—
296403
AV MED
FL
Enumeration date
09/28/2006
Last updated
07/08/2007
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