Individual
WAYNE MAVELLIA II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
557 BROOKDALE DR, STATESVILLE, NC 28677-4107
(704) 873-5661
Mailing address
557 BROOKDALE DR, STATESVILLE, NC 28677-4107
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
7744
NC
Other
Enumeration date
03/18/2024
Last updated
11/11/2025
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