Individual
DR. WAYNE J REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5659 PARKWAY DR, STE 210, GLOUCESTER, VA 23061-3792
(804) 210-1025
(804) 210-1029
Mailing address
5659 PARKWAY DR, STE 210, GLOUCESTER, VA 23061-3792
(804) 210-1025
(804) 210-1029
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102049941
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005630789
—
VA
05
—
005829275
—
VA
05
—
010118433
—
VA
Enumeration date
02/21/2006
Last updated
02/01/2012
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