MEDICARE: DR. WAYNE ANDREW HALE 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	207Q00000X	Family Medicine Physician	30355	NC
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	30355	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9074	OTHER	NC	PARTNERS MEDICARE CHOICE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	5184053	OTHER	NC	AETNA
3	38276	OTHER	NC	BCBS NC
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	24818	OTHER	NC	MEDCOST

General Provider Information

NPI Number	:	1295782753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAYNE ANDREW HALE M.D.

Provider Business Mailing Address
First Line	:	1200 N ELM ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-1004
Country	:	US
Telephone Number	:	336-832-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1125 N CHURCH ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-1007
Country	:	US
Telephone Number	:	336-832-8035
Fax Number	:

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

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	04/05/2013

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