Smith, Wayne
Smith, Wayne is an individual health care provider with primary practice located at 3210 Eagle Run Dr Ne Ste 100 , Grand Rapids MI 49525-7051. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Occupational Medicine. Allopathic & Osteopathic Physicians / Occupational Medicine is his primary health care specialty. Smith, Wayne can be contacted via phone (616) 279-3725.Contact Information
Primary practice address
3210 Eagle Run Dr Ne Ste 100
Grand Rapids MI 49525-7051
Phone: (616) 279-3725
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 5101011102 | Michigan |
| Allopathic & Osteopathic Physicians / Occupational Medicine | 2083X0100X | 5101011102 | Michigan |
Profile Details
| NPI number | 1205842101 |
|---|---|
| LBN Legal business name | Smith, Wayne |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Nov 21st, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205842101 | NPPES |
| Michigan | MEDICAID | 4615238 |
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