Provider Demographics
NPI:1184670481
Name:CHIN, WAYNE YUCK (DPM)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:YUCK
Last Name:CHIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:20190 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ONANCOCK
Mailing Address - State:VA
Mailing Address - Zip Code:23417-1330
Mailing Address - Country:US
Mailing Address - Phone:757-789-3402
Mailing Address - Fax:757-789-3862
Practice Address - Street 1:20190 MARKET ST
Practice Address - Street 2:
Practice Address - City:ONANCOCK
Practice Address - State:VA
Practice Address - Zip Code:23417-1330
Practice Address - Country:US
Practice Address - Phone:757-789-3402
Practice Address - Fax:757-789-3862
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300934213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1184670481Medicaid
VAV07997Medicare UPIN