Provider Demographics
NPI:1235118860
Name:WAYBRIGHT, EDWARD A (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:A
Last Name:WAYBRIGHT
Suffix:
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 1:10 MINOT AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-4900
Mailing Address - Country:US
Mailing Address - Phone:207-795-2927
Mailing Address - Fax:207-795-2000
Practice Address - Street 1:10 MINOT AVE
Practice Address - Street 2:STE 404
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-4900
Practice Address - Country:US
Practice Address - Phone:207-795-2927
Practice Address - Fax:207-795-2000
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0151442084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEB59849Medicare UPIN
MEMM804001Medicare UPIN
MEMM804002Medicare UPIN
MENX2053Medicare UPIN