Provider Demographics
NPI:1811980261
Name:SUMPTER, WAYNE K (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:K
Last Name:SUMPTER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
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Mailing Address - Street 1:2501 CAPEHART RD
Mailing Address - Street 2:
Mailing Address - City:OFFUTT AFB
Mailing Address - State:NE
Mailing Address - Zip Code:68113-1043
Mailing Address - Country:US
Mailing Address - Phone:402-294-7346
Mailing Address - Fax:402-294-9138
Practice Address - Street 1:2501 CAPEHART RD
Practice Address - Street 2:
Practice Address - City:OFFUTT AFB
Practice Address - State:NE
Practice Address - Zip Code:68113-1043
Practice Address - Country:US
Practice Address - Phone:402-294-7346
Practice Address - Fax:402-294-9138
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE24255207Q00000X, 207Q00000X
CAG679242083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine