Wivell, Wayne Albert

Wivell, Wayne Albert is an individual health care provider with primary practice located at 6716 Nw 11Th Pl Ste 200 , Gainesville FL 32605-4201. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Wivell, Wayne Albert can be contacted via phone (352) 331-9729.

Contact Information

Primary practice address
6716 Nw 11Th Pl Ste 200 Gainesville FL 32605-4201
Phone: (352) 331-9729
Fax: (352) 331-0136
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X ME145109 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 81971 Massachusetts
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 81971 Massachusetts
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME145109 Florida

Profile Details

NPI number 1912980079
LBN Legal business name Wivell, Wayne Albert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2005
Last updated Mar 10th, 2022 - about 2 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 1912980079 NPPES
Florida Other MQ512 MEDICARE
Florida MEDICAID 106807000 MEDICARE
Florida Other MQ511 MEDICARE
Florida Other 7CZ1B MEDICARE

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