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Individual

E. M. BRENDAN WYATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20641
AL
207W00000X
Ophthalmology Physician
ME167191
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000002044
AL
05
009976795
AL
01
051002044
BLUE CROSS BLUE SHIELD
AL
01
051525773
BLUE CROSS BLUE SHIELD
AL
Enumeration date
07/27/2006
Last updated
08/19/2026
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