Healthcare Provider Details

I. General information

NPI: 1649679754
Provider Name (Legal Business Name): WAYNE E HACHEY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 LAUREL CT
NELLYSFORD VA
22958-9554
US

IV. Provider business mailing address

11 LAUREL CT
NELLYSFORD VA
22958-9554
US

V. Phone/Fax

Practice location:
  • Phone: 434-465-0051
  • Fax:
Mailing address:
  • Phone: 434-465-0051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberH0041544
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberH0041544
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: