Healthcare Provider Details

I. General information

NPI: 1871441147
Provider Name (Legal Business Name): SYDNEY WAYAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2280 IVY RD STE 1303
CHARLOTTESVILLE VA
22903-4977
US

IV. Provider business mailing address

PO BOX 749112
ATLANTA GA
30374-9112
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-2301
  • Fax: 434-982-1727
Mailing address:
  • Phone: 434-295-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110012110
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: