Provider Demographics
NPI:1720222052
Name:YOUNG, WAYNE E (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:E
Last Name:YOUNG
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 1:42 HUMMINGBIRD CT
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-8344
Mailing Address - Country:US
Mailing Address - Phone:740-574-9049
Mailing Address - Fax:
Practice Address - Street 1:42 HUMMINGBIRD CT
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-8344
Practice Address - Country:US
Practice Address - Phone:740-574-9049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35047951208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice