Provider Demographics
NPI:1346252186
Name:ARNOLD, WAYNE V (DO)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:V
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-9998
Mailing Address - Country:US
Mailing Address - Phone:610-660-0800
Mailing Address - Fax:610-660-0360
Practice Address - Street 1:2 BALA PLZ STE PL20
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1501
Practice Address - Country:US
Practice Address - Phone:610-660-0800
Practice Address - Fax:610-660-0360
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004637L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009298300003Medicaid
PA169021Medicare ID - Type Unspecified
PA0009298300003Medicaid