Individual
MARTHA R WAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5400 E. TEXAS ST, BOSSIER CITY, LA 71111
(318) 675-1313
(888) 965-0619
Mailing address
5400 E. TEXAS ST, BOSSIER CITY, LA 71111
(318) 675-1313
(888) 965-0619
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
026448
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05981
—
LA
Enumeration date
06/04/2007
Last updated
12/15/2022
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