Individual
DR. MAC THEODORE WAYMENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1700 PRAIRIE CITY RD, FOLSOM, CA 95630-9594
(916) 351-4800
(916) 351-4899
Mailing address
3400 DATA DR, PHYSICIAN SUPPORT SERVICES, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
20A 9172
CA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
20A9172
CA
Other
Enumeration date
05/04/2007
Last updated
11/10/2023
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