Provider Demographics
NPI:1164414926
Name:SEASE, WAYNE FRANKLIN JR (MD)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:FRANKLIN
Last Name:SEASE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:315 MEDICAL PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-2456
Practice Address - Country:US
Practice Address - Phone:864-454-7422
Practice Address - Fax:864-797-9701
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21083207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00801273OtherRR MEDICARE
NC8913461Medicaid
SCP00464118OtherRR MEDICARE
SCG916327951Medicare PIN
SCP00801273OtherRR MEDICARE
G91632Medicare UPIN
SCG916327951Medicare PIN