Individual
DR. WAYNE A STOUTENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 JENNIE DR, YORKTOWN, VA 23692-4001
(757) 817-4667
(800) 655-5268
Mailing address
105 JENNIE DR, YORKTOWN, VA 23692-4001
(757) 817-4667
(800) 655-5268
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101050796
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101050796
VA LICENSE
VA
01
—
1619178274
NPI
—
01
—
A102018
PTAN
VA
Enumeration date
05/30/2007
Last updated
09/30/2011
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