Wynn, Vander M
Wynn, Vander M is an individual health care provider with primary practice located at 5309 Waterview Dr , North Port FL 34291-8032. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Wynn, Vander M can be contacted via phone (239) 261-1158.Contact Information
Primary practice address
5309 Waterview Dr
North Port FL 34291-8032
Phone: (239) 261-1158
Fax: (239) 261-4232
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | ME66148 | Florida |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 281372 | New York |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 075180 | Georgia |
Profile Details
| NPI number | 1497866040 |
|---|---|
| LBN Legal business name | Wynn, Vander M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
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 | 1497866040 | NPPES |
| Other | 050029800 | RAILROAD MEDICARE | |
| MEDICAID | 375454500 | RAILROAD MEDICARE | |
| Other | 25438 | RAILROAD MEDICARE |
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