Healthcare Provider Details

I. General information

NPI: 1245445162
Provider Name (Legal Business Name): EYAD M WOHAIBI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 03/14/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 WEHRLE DR STE 300
WILLIAMSVILLE NY
14221-7099
US

IV. Provider business mailing address

2150 WEHRLE DR STE 300
WILLIAMSVILLE NY
14221-7099
US

V. Phone/Fax

Practice location:
  • Phone: 716-453-5200
  • Fax: 716-710-8075
Mailing address:
  • Phone: 716-453-5200
  • Fax: 716-710-8075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number257881-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number87627915
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: