Individual
MR. WAYNE GERARD AUGUSTYNIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2889 SOUTH 11TH STREET, KALAMAZOO, MI 49009-2123
(269) 343-1247
(269) 343-6661
Mailing address
2889 S 11TH ST, KALAMAZOO, MI 49009-2123
(269) 343-1247
(269) 343-6661
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601001009
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601001009
STATE LICENCE NUMBER
MI
Enumeration date
08/16/2005
Last updated
12/02/2010
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