MEDICARE: DR. WAYNE K KAWALEK MD

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	207P00000X	Emergency Medicine Physician	35-04-6206	OH
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	AK35046206	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063514784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAYNE K KAWALEK MD

Provider Business Mailing Address
First Line	:	7601 FIRST PL STE 7A
Second Line	:
City	:	OAKWOOD VILLAGE
State	:	OH
Zip	:	44146-6702
Country	:	US
Telephone Number	:	440-552-9454
Fax Number	:

Provider Business Practice Location Address
First Line	:	7601 FIRST PL
Second Line	:
City	:	OAKWOOD VILLAGE
State	:	OH
Zip	:	44146-6716
Country	:	US
Telephone Number	:	440-552-9454
Fax Number	:	440-945-6368

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

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	01/19/2024

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Directions to “ DR. WAYNE K KAWALEK MD” Practice Location

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