Individual
GARY EDWIN WYARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 S MAPLE ST, WACONIA, MN 55387-1715
(952) 442-2163
(952) 442-5903
Mailing address
6465 WAYZATA BLVD, SUITE 900, ST LOUIS PARK, MN 55426-1728
(952) 512-5600
(952) 512-5650
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
18682
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10241E948
UCARE
—
01
—
73B30WY
BLUECROSS BLUESHIELD
—
01
—
928624
MEDICA
—
01
—
969990824016
PREFERREDONE
—
01
—
HP14727
HEALTHPARTNERS
—
Enumeration date
08/23/2006
Last updated
07/11/2007
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