Carlson, Wayne A

Carlson, Wayne A is an individual health care provider with primary practice located at 2122 Grange Rd , Buchanan MI 49107-9367. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Carlson, Wayne A can be contacted via phone (269) 471-5186.

Contact Information

Primary practice address
2122 Grange Rd Buchanan MI 49107-9367
Phone: (269) 471-5186
Fax: (269) 471-5086
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 064990 Michigan

Profile Details

NPI number 1548202450
LBN Legal business name Carlson, Wayne A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jul 29th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548202450 NPPES
Michigan Other WC064990 BC/BS
Michigan MEDICAID 200981120 BC/BS
Michigan MEDICAID 4700197 BC/BS
Michigan MEDICAID 4707975 BC/BS

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