MICHAEL L WYNN I (NPI# 1750332516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750332516 |
Entity Type | Individual |
Full Name | MICHAEL L WYNN I |
Credential | D.O. |
Practice Address |
1655 Liberty St Se Salem OR 97302-4347 |
Practice Telephone | 5035817959 |
Practice Fax Number | 5033624114 |
Mailing Telephone | 5035817959 |
Mailing Fax Number | 5033624114 |
Enumeration Date | 2006-05-15 |
Last Update Date | 2016-06-21 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
DO15695 | OR | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 203505 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912344516 | Michael Wynn | Dentist | 2820 E 57th Pl, Tulsa, OK 74105-7408 | 2013-05-23 |
1285683995 | Michael Minh Wynn | Dentist | 408 S Beach Blvd Ste 210, Anaheim, CA 92804-1887 | 2006-05-09 |
1013919471 | Michael Hanlon Wynn | Podiatrist | 23972a Highway 59 N, Kingwood, TX 77339-1535 | 2005-08-15 |
1689778722 | Michael Preston Wynn | Family Medicine | 10625 W Parmer Ln, D400, Austin, TX 78717-4007 | 2006-09-11 |
1285673996 | Michael Lee Wynn | Surgery | 5601 Norris Canyon Rd, Ste 100, San Ramon, CA 94583-5407 | 2006-06-06 |
Street Address |
1655 LIBERTY ST SE |
City | SALEM |
State | OR |
Zip Code | 97302-4347 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396304291 | Kira Mariah Biron | Registered Nurse | 1655 Liberty St Se, Salem, OR 97302-4347 | 2019-06-13 |
1639491525 | Robert Arthur Lee | Dentist | 1655 Liberty St Se, Salem, OR 97302-4347 | 2010-02-19 |
1629285143 | Liberty Dental Care PC | Dentist | 1655 Liberty St Se, Salem, OR 97302-4347 | 2007-05-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
Find all providers in zip 97302 |
Taxonomy Code | 2084N0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology |
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104025634 | Thye Matthew Schuyler | Psychiatry & Neurology | Salem Health Sleep Center, 875 Oak St Se, Bldg C, Suite 3060, Salem, OR 97301-3975 | 2007-07-14 |
1124193727 | Donna Marie Capin | Psychiatry & Neurology | North Shore Children's Hospital, 57 Highland Ave, Salem, MA 01970 | 2006-11-21 |
1013944016 | Benton John Davidson | Psychiatry & Neurology | 1174 Cornucopia St Nw, Suite 240, Salem, OR 97304-3193 | 2006-06-26 |
1962447730 | Keifong William Seeto | Psychiatry & Neurology | 960 Liberty St Se, Suite 140, Salem, OR 97302-4165 | 2006-06-17 |
1033183249 | Valley Neurology Associates PC | Psychiatry & Neurology | 1904 Braeburn Dr, Salem, VA 24153 | 2006-02-14 |
1689648883 | Howard B Sherman | Psychiatry & Neurology | 1942 Braeburn Cir, Salem, VA 24153-7388 | 2006-02-14 |
1447247630 | James A Whitlock | Psychiatry & Neurology | 70 Butler St, Salem, NH 03079-3925 | 2005-10-03 |
1669470670 | Kenten D Woolhiser | Psychiatry & Neurology | 966 12th St Se, Salem, OR 97302-2859 | 2005-07-13 |
1770997009 | Urooba Faheem | Psychiatry & Neurology | 875 Oak St Se, Salem, OR 97301-3975 | 2014-06-14 |
1548515737 | Syed Omar Yousuf Kazmi | Psychiatry & Neurology | 890 Oak St Se, Salem, OR 97301-3905 | 2012-07-13 |
Find all providers in SALEM |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.