Individual
BETH ANN WAYWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1040 PINNACLE POINT DRIVE, COL, SC 29223
(803) 509-7200
(803) 509-7213
Mailing address
1040 PINNACLE POINT DRIVE, COLUMBIA, SC 29223
(803) 509-7200
(803) 509-7213
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
23002055A
IN
231H00000X
Audiologist
Primary
3940
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000343052
ANTHEM
—
05
—
200060920
—
IN
01
—
P00818653
RAILROAD MEDICARE
IN
01
—
P00844267
RAILROAD MEDICARE
IN
Enumeration date
08/30/2006
Last updated
03/17/2018
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