Individual
DR. DANIELLE MARIE WAYMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1320 PABST FARMS CIR UNIT 180, OCONOMOWOC, WI 53066-4878
(262) 560-0322
(262) 560-0379
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
71076-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101767
—
OH
Enumeration date
12/20/2011
Last updated
05/22/2019
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