Individual
DR. DANIEL MAC DOWELL WAYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 BLACK OAK DR, SUITE 210, MEDFORD, OR 97504-8447
(541) 734-3540
(541) 734-3597
Mailing address
555 BLACK OAK DR, SUITE 210, MEDFORD, OR 97504-8447
(541) 734-3540
(541) 734-3597
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
MD17390
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027792
—
OR
01
—
4004301-01
BLUE CROSS
OR
01
—
931274301
TAX ID
OR
01
—
G62052
MEDICAL LIC CALIF
CA
01
—
MD17390
MEDICAL LIC OR
OR
01
—
XPY124720
MEDICAL ID
CA
Enumeration date
11/21/2006
Last updated
03/07/2023
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