Wayburn, Lawrence G
Wayburn, Lawrence G is an individual health care provider with primary practice located at 2 Big Bear Pl , Santa Fe NM 87508. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Wayburn, Lawrence G can be contacted via phone (989) 928-2397.Contact Information
Primary practice address
2 Big Bear Pl
Santa Fe NM 87508
Phone: (989) 928-2397
Fax: (505) 471-4388
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD2007-0243 | New Mexico |
Profile Details
| NPI number | 1891790192 |
|---|---|
| LBN Legal business name | Wayburn, Lawrence G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2005 |
| Last updated | Jun 10th, 2016 - about 8 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 | 1891790192 | NPPES |
| Other | 1891790192 | NPI | |
| MEDICAID | 51282551 | NPI | |
| MEDICAID | 4542150 | NPI |
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