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NPI Code Detail

MEDICARE: WAYNE G SPRONK MD

MEDICARE: WAYNE G SPRONK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician205274NY
2207R00000XInternal Medicine Physician205274NY
3208M00000XHospitalist Physician205274NY

General Provider Information

NPI Number : 1407911720
Entity Type Code : Individual
Provider Name (Legal Business Name) : WAYNE G SPRONK MD
Provider Business Mailing Address
First Line : 100 KINGS HWY S
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5504
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1555 LONG POND RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14626-4164
Country : US
Telephone Number : 585-723-7870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2006
Last Update Date : 01/13/2025

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