Individual
MR. WAYNE B SIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
917 BYPASS 225 S, GREENWOOD, SC 29646-8025
(864) 227-5240
(864) 227-5239
Mailing address
P.O. BOX 3193, GREENWOOD, SC 29648
(864) 227-5240
(864) 227-5239
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
18456
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130024564
RR MEDICARE
SC
05
—
184561
—
SC
Enumeration date
07/28/2005
Last updated
09/04/2015
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