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General NPI Number Information
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NPI Number | 1376723171
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Entity Type | Organization
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Legal Business Name | MARILYN A WAHE MD PA
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 700 2ND AVE N STE 203
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City | NAPLES
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State | FL
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Zip | 34102-5701
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Country | US
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Telephone | 239-643-8055
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Fax | 239-403-4909
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Provider Business Mailing Address
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Address Line | 700 2ND AVE N STE 203
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City | NAPLES
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State | FL
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Zip | 34102-5701
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Country | US
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Telephone | 239-643-8055
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Fax | 239-403-4909
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Authorized Official
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Title or Position | CEO
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Name | DR. MARILYN A WAHE
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Credential | MD
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Telephone | 239-643-8055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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