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General NPI Number Information
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NPI Number | 1750418828
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Entity Type | Individual
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Provider Name | WAYNE ROBERT BUCHWALD DO
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Gender | Male
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 10/10/2018
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Provider Practice Location Address
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Address Line | 1700 WHEELER PEAK DR.
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City | LAS VEGAS
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State | NV
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Zip | 89106
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Country | US
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Telephone | 702-383-2565
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Fax | 702-646-0298
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Provider Business Mailing Address
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Address Line | 1800 W. CHARLESTON BLVD. STE. 508
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City | LAS VEGAS
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State | NV
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Zip | 89102
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Country | US
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Telephone | 702-383-2688
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Fax | 702-671-6595
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 451
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 451
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License Number State | NV
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