Individual
DR. MITCHELL S WAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
7001 ORCHARD LAKE RD, SUITE 230B, WEST BLOOMFIELD, MI 48322-3604
(248) 855-3232
(248) 855-3232
Mailing address
7001 ORCHARD LAKE RD, SUITE 230B, WEST BLOOMFIELD, MI 48322-3604
(248) 855-3232
(248) 855-3232
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
5901400097
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000012402
CAPE HEALTH PLAN
MI
01
—
10105530003
WELLNESS PLAN
MI
01
—
506728
CARE CHOICES
MI
01
—
T34163
HAP
MI
Enumeration date
02/02/2006
Last updated
01/08/2008
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