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Individual
DR. WAYNE A STOUTENGER
Active
Individual
DR. WAYNE A STOUTENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101050796
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101050796
VA LICENSE
VA
01
—
1619178274
NPI
—
01
—
A102018
PTAN
VA
Enumeration date
05/30/2007
Last updated
09/30/2011
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