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1043232606

NPI Code Detail

MEDICARE: WAYNE BEAUFORD M.D.

MEDICARE: WAYNE BEAUFORD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0201X	Allergy & Immunology (Internal Medicine) Physician	35265	NC
2	207RP1001X	Pulmonary Disease Physician	35265	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2171290D	OTHER	NC	MEDICARE PTAN
2	2171290A	OTHER	NC	MEDICARE PTAN
3	2171290E	OTHER	NC	MEDICARE PTAN

General Provider Information

NPI Number	:	1043232606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAYNE BEAUFORD M.D.

Provider Business Mailing Address
First Line	:	645 N MAIN ST
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27260-5017
Country	:	US
Telephone Number	:	336-883-0029
Fax Number	:	336-899-2188

Provider Business Practice Location Address
First Line	:	507 N LINDSAY ST
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27262-4303
Country	:	US
Telephone Number	:	336-883-0029
Fax Number	:	336-883-0867

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/19/2024

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Directions to “ WAYNE BEAUFORD M.D.” Practice Location

Language	Start Address	Practice Location

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