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General NPI Number Information
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NPI Number | 1215993449
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Entity Type | Individual
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Provider Name | WAYNE D BIERBAUM M.D
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 134 OWENSVILLE RD
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City | WEST RIVER
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State | MD
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Zip | 20778-9998
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Country | US
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Telephone | 410-867-4700
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Fax | 410-867-4934
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Provider Business Mailing Address
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Address Line | 3106 NEWCASTLE LN
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City | RIVA
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State | MD
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Zip | 21140-1417
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Country | US
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Telephone | 410-956-5033
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0038563
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License Number State | MD
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