Individual
DR. WAYNE A. MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
011739
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001862
ANTHEM
—
01
—
010416156
TRAVELERS/CORE/MEDNET
—
01
—
015612
MEDICARE
—
01
—
0378600001
DMERC
—
01
—
100294000
USPS WC
—
01
—
1044480
AETNA
—
01
—
200009601
RR MEDICARE
—
01
—
201017
MEDICARE ASC FACILITY
—
01
—
270310099
MAINECARE
ME
01
—
D03588
HARVARD
—
01
—
DX4496
NEW MEDICARE PTAN
—
01
—
M4231
CIGNA
—
01
—
MM0716
MEDICARE CLINIC FACILITY
—
Enumeration date
06/15/2005
Last updated
07/12/2011
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