| Doctor Name: | MARSHALL A WAKAT |
| NPI Number: | 1023033966 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 0101027227 |
| Business Practice Address: | 1906 Belleview Ave Se Roanoke, VA - 240141838 |
| Business Phone Number: | 5409817553 |
| Business Fax Number: | 5403422789 |
| Mailing Address: | Po Box 12668, ROANOKE |
| State: | VA |
| Postal Code: | 240272668 |
| Phone Number: | 5409817553 |
| Fax Number: | 5403422789 |
| NPI Enumeration Date: | 07/13/2006 |
| NPI Last Update Date: | 11/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 0101027227 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |