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Individual
WAYNE JEFFERSON BERRY II
Active
Individual
WAYNE JEFFERSON BERRY II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101240108
VA
207Q00000X
Family Medicine Physician
35098
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010321310
—
VA
01
—
1518A
BCBS
NC
01
—
1790764009
NPI
VA
01
—
540490687003
TRICARE
VA
05
—
891518A
—
NC
Enumeration date
01/13/2006
Last updated
05/22/2025
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