Individual
DR. LARRY WYATT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2201 CHAPEL AVE W, KENNEDY MEMORIAL HOSPITAL-UMC, CHERRY HILL, NJ 08002-2048
(856) 488-6560
(856) 488-6546
Mailing address
PO BOX 635, BELLMAWR, NJ 08099-0635
(856) 770-5772
(856) 566-2797
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
Primary
MB032175
NJ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MB032175
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3856909
—
NJ
Enumeration date
01/23/2006
Last updated
09/11/2025
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