Provider Demographics
NPI:1033554597
Name:HU, WAYNE CALVIN (DO)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:CALVIN
Last Name:HU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4420 LAKE BOONE TRL STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-7505
Mailing Address - Country:US
Mailing Address - Phone:984-215-6950
Mailing Address - Fax:984-215-6951
Practice Address - Street 1:4420 LAKE BOONE TRL STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7505
Practice Address - Country:US
Practice Address - Phone:984-215-6950
Practice Address - Fax:984-215-6951
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS15370208100000X
NC2023-00295208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation