Individual
GARY JAY WAXMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
816 INDEPENDENCE BLVD, STE 2A, VIRGINIA BEACH, VA 23455-6010
(757) 363-6712
(757) 363-6204
Mailing address
816 INDEPENDENCE BLVD, STE 2A, VIRGINIA BEACH, VA 23455-6010
(757) 363-6712
(757) 363-6204
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101059225
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010125529
—
VA
Enumeration date
10/21/2005
Last updated
03/05/2009
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