Individual
DR. WYMAN BETHUNE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
UNIVERSITY HOSPITAL L2, STONY BROOK, NY 11794-0001
(631) 444-2210
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-2210
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
169300
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01129419
—
NY
01
—
36E292
EMPIRE B/C B/S
NY
01
—
4323856
AETNA
NY
Enumeration date
06/04/2006
Last updated
07/08/2007
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