Provider Demographics
NPI:1023098704
Name:MCNETT, WAYNE F (MD)
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:F
Last Name:MCNETT
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 1:8840 CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:VA
Mailing Address - Zip Code:22812-3705
Mailing Address - Country:US
Mailing Address - Phone:540-828-0842
Mailing Address - Fax:
Practice Address - Street 1:1661 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-2728
Practice Address - Country:US
Practice Address - Phone:540-564-7300
Practice Address - Fax:757-431-7100
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-030939207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1023098704Medicaid
VA19822OtherOPTIMA
VA014552R54Medicare PIN
VA6677230OtherCIGNA
B07578Medicare UPIN
VA1000870001OtherDME PROVIDER
VA1023098704Medicaid
VA638326OtherSOUTHERN HEALTH
VA3810009117OtherWV MEDICAID