Provider Demographics
NPI:1215930458
Name:FURMAN, WAYNE L (MD)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:L
Last Name:FURMAN
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 1:262 DANNY THOMAS PL
Mailing Address - Street 2:MS 515
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-3678
Mailing Address - Country:US
Mailing Address - Phone:901-595-3006
Mailing Address - Fax:901-595-3842
Practice Address - Street 1:262 DANNY THOMAS PL
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-3678
Practice Address - Country:US
Practice Address - Phone:901-595-3006
Practice Address - Fax:901-595-3842
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN146172080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME422400000Medicaid
TN3808896Medicaid
GA326144190AMedicaid
IA0527648Medicaid
NC7612991Medicaid
LA1533866Medicaid
MO204895908Medicaid
NV100507257Medicaid
AR132438001Medicaid
OH2004431Medicaid
AZ715352Medicaid
NJ0030520Medicaid
MI104818491Medicaid
KY64926629Medicaid
MS00118058Medicaid
MT0142086Medicaid
IN200181370AMedicaid
TN3808896Medicaid
AZ715352Medicaid