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Individual
DR. WAYNE S WAHL
Active
Individual
DR. WAYNE S WAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301039553
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08OG21014
BCBS
MI
05
—
4737400
—
MI
05
—
4737419
—
MI
05
—
4737446
—
MI
05
—
4758830
—
MI
05
—
4758858
—
MI
01
—
P00258733
RAILROAD MEDICARE
MI
Enumeration date
05/15/2006
Last updated
01/08/2008
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