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Individual

WAYNE JEFFERSON BERRY II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
759 S MAIN ST, WOODSTOCK, VA 22664-1127
(540) 459-1100
Mailing address
199 GLENDOBBIN LANE, WINCHESTER, VA 22603
(540) 535-1645

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101240108
VA
207Q00000X
Family Medicine Physician
35098
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010321310
VA
01
1518A
BCBS
NC
01
1790764009
NPI
VA
01
540490687003
TRICARE
VA
05
891518A
NC
Enumeration date
01/13/2006
Last updated
05/22/2025
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