Individual
DR. HARLAN SAMPLE WAID JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 S CHESTNUT ST, JEFFERSON, OH 44047-1312
(440) 576-9111
Mailing address
125 S CHESTNUT ST, JEFFERSON, OH 44047-1312
(440) 576-9111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35047304
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0483838
—
OH
Enumeration date
10/07/2005
Last updated
12/21/2012
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