Provider Demographics
NPI:1477619856
Name:TOBIN, H WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:H
Middle Name:WAYNE
Last Name:TOBIN
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:PO BOX 1261
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28302-1261
Mailing Address - Country:US
Mailing Address - Phone:910-826-3694
Mailing Address - Fax:910-826-3695
Practice Address - Street 1:911 HAY ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5313
Practice Address - Country:US
Practice Address - Phone:910-438-0939
Practice Address - Fax:910-438-0942
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000003272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891328CMedicaid
1328COtherBLUE CROSS BLUE SHIELD
NC2280428Medicare ID - Type Unspecified
NCD79279Medicare UPIN
NC2280428KMedicare PIN
NC891328CMedicaid
NC2280428HMedicare PIN