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General NPI Number Information
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NPI Number | 1609834795
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Entity Type | Individual
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Provider Name | ALLAN SCOTT WAX DPM
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Gender | Male
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 12/05/2017
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Provider Practice Location Address
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Address Line | 13048 RIVERS BEND RD
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City | CHESTER
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State | VA
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Zip | 23836-2564
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Country | US
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Telephone | 804-526-5888
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Fax | 804-526-5401
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Provider Business Mailing Address
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Address Line | 13000 RIVERS BEND BLVD SUITE D
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City | CHESTER
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State | VA
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Zip | 23836-8632
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Country | US
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Telephone | 804-571-5106
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Fax | 804-530-3015
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0103000780
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License Number State | VA
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