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Individual
WAYNE LARSON
Active
Individual
WAYNE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01081854A
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
ME148416
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110682900
—
FL
Enumeration date
04/30/2015
Last updated
07/22/2021
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