Wynn, Mary E

Wynn, Mary E is an individual health care provider with primary practice located at 1061 Harmon Ave Suite 1D03, Fort Stewart GA 31314-5641. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wynn, Mary E can be contacted via phone (912) 435-6633.

Contact Information

Primary practice address
1061 Harmon Ave Suite 1D03 Fort Stewart GA 31314-5641
Phone: (912) 435-6633
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 36.12214 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35.061059 Ohio

Profile Details

NPI number 1356310486
LBN Legal business name Wynn, Mary E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Nov 29th, 2011 - about 13 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 1356310486 NPPES
Ohio MEDICAID 0837670

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