MEDICARE: DR. WAYNE WING FAI LI D.O.

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	OS019337	PA

General Provider Information

NPI Number	:	1538589288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAYNE WING FAI LI D.O.

Provider Business Mailing Address
First Line	:	1380 EASTON RD
Second Line	:
City	:	WARRINGTON
State	:	PA
Zip	:	18976-1818
Country	:	US
Telephone Number	:	215-491-5063
Fax Number	:

Provider Business Practice Location Address
First Line	:	1380 EASTON RD
Second Line	:
City	:	WARRINGTON
State	:	PA
Zip	:	18976-1818
Country	:	US
Telephone Number	:	215-491-5063
Fax Number	:

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

Provider Enumeration Date	:	04/21/2014
Last Update Date	:	09/13/2023

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