Individual
DAVID A WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 CRYSTAL SPRING AVE SW STE 201, ROANOKE, VA 24014-2465
(540) 853-0100
(540) 342-9308
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5715
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
0101037626
VA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
29821
TN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD.16927
AL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
ME98555
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278324000
—
FL
05
—
3723206
—
TN
05
—
3820393
—
TN
01
—
4070506
BCBSTN
TN
01
—
DB4643
RAILROAD MEDICARE
TN
01
—
P00107052
RAILROAD MEDICARE
TN
Enumeration date
11/10/2006
Last updated
04/08/2026
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