Organization Name: | WAYNE GROUP SYSTEMS, INC. |
NPI Number: | 1720276942 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NEYSIS MONTALVO (PRESIDENT) |
Mailing Address: | 2074 S Wayne Rd Westland |
State: | MI US |
Postal Code: | 481865428 |
Phone Number: | 7347228054 |
Fax Number: | 7347228419 |
NPI Enumeration Date: | 10/12/2007 |
NPI Last Update Date: | 01/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |