Organization
MITCHELL S. WAYNE, DPM, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL S WAYNE DPM (PRESIDENT/OWNER)
(248) 855-3232
Entity
Organization
Contact information
Practice address
7001 ORCHARD LAKE RD, SUITE 230B, WEST BLOOMFIELD, MI 48322-3604
(248) 855-3232
(248) 855-3338
Mailing address
7001 ORCHARD LAKE RD, SUITE 230B, WEST BLOOMFIELD, MI 48322-3604
(248) 855-3232
(248) 855-3338
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
5901400097
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F372270
BCBSM
MI
01
—
4479604
AETNA HEALTHCARE
MI
01
—
611678400
DEPARTMENT OF LABOR
MI
01
—
80395A
HEALTH PLUS OF MICHIGAN
MI
01
—
CE9028
RAILROAD MEDICARE
MI
Enumeration date
02/02/2006
Last updated
07/25/2008
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