Provider Demographics
NPI:1659438737
Name:WAYNE C. STUART, MD, PC
Entity Type:Organization
Organization Name:WAYNE C. STUART, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:STUART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-653-7681
Mailing Address - Street 1:2053 MAJESTIC OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-5506
Mailing Address - Country:US
Mailing Address - Phone:610-653-7681
Mailing Address - Fax:610-954-0744
Practice Address - Street 1:2053 MAJESTIC OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-5506
Practice Address - Country:US
Practice Address - Phone:610-653-7681
Practice Address - Fax:610-954-0744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051543L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF89849Medicare UPIN