Gary W Wake (NPI# 1063409084, PAC ID# 4981662483) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1063409084 |
| PAC ID by PECOS | 4981662483 |
| Professional Enrollment ID | I20041230000335 |
| Full Name | Gary W Wake |
| Organization Legal Name | NORTHWESTERN COMMUNITY SERVICES BOARD |
| Address |
441 N Main St Woodstock VA 22664-1801 |
| Phone Number | 5404594946 |
| Gender | M |
| Credential | MD |
| Medical School | MEDICAL COLLEGE OF VIRGINIA COMMONWEALTH UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1965 |
| Primary Specialty | FAMILY PRACTICE |
| Secondary Specialties | PSYCHIATRY |
| Group Practice PAC ID | 2769371251 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 441 N Main St, Woodstock, VA 22664-1801 | 5404594946 | NORTHWESTERN COMMUNITY SERVICES BOARD |
| Organization Legal Name | NORTHWESTERN COMMUNITY SERVICES BOARD |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lacy J Jordan White | Clinical Social Worker | Northwestern Community Services Board | 209 W Criser Rd, Suite 100, Front Royal, VA 22630-2360 |
| Lisa M Clement Defalco | Nurse Practitioner | Northwestern Community Services Board | 158 Front Royal Pike, Suite 200, Winchester, VA 22602-4324 |
| Elizabeth A Sampson | Nurse Practitioner | Northwestern Community Services Board | 494 N Main St, Suite 300, Woodstock, VA 22664-1703 |
| Lakuma R Mogili | Psychiatry | Northwestern Community Services Board | 158 Front Royal Pike, Suite 200, Winchester, VA 22602-4324 |
| Sue St Clair | Nurse Practitioner | Northwestern Community Services Board | 158 Front Royal Pike, Suite 200, Winchester, VA 22602-4324 |
| Marian O Newton | Nurse Practitioner | Northwestern Community Services Board | 209 W Criser Rd, Suite 100, Front Royal, VA 22630-2360 |
| George Dupuy | Clinical Social Worker | Northwestern Community Services Board | 209 W Criser Rd, Suite 100, Front Royal, VA 22630-2360 |
| Swarna B Reddy | Psychiatry | Northwestern Community Services Board | 158 Front Royal Pike, Suite 200, Winchester, VA 22602-4324 |
| Charles Robert Goshen | Psychiatry | Northwestern Community Services Board | 209 W Criser Rd, Suite 100, Front Royal, VA 22630-2360 |
| Elizabeth C Trefzger | Psychiatry | Northwestern Community Services Board | 209 W Criser Rd, Suite 100, Front Royal, VA 22630-2360 |
| Street Address |
441 N MAIN ST |
| City | WOODSTOCK |
| State | VA |
| Zip | 22664-1801 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elisa L Robertson | Clinical Social Worker | County of Modoc | 441 N Main St, Alturas, CA 96101-3457 |
| Vanessa Ann Sweat-britt | Nurse Practitioner | Ohio Valley Physicians Inc | 441 N Main St, Sumter, SC 29150-4232 |
| Alisha A Romesha | Clinical Social Worker | County of Modoc | 441 N Main St, Alturas, CA 96101-3457 |
| Dolores C Navarro Turner | Clinical Social Worker | County of Modoc | 441 N Main St, Alturas, CA 96101-3457 |
| Sherief H El-mallah | Psychiatry | Northwestern Community Services Board | 441 N Main St, Woodstock, VA 22664-1801 |
| Faye A Branum | Physician Assistant | County of Modoc | 441 N Main St, Alturas, CA 96101-3457 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Susan C Moose | Internal Medicine | Shenandoah Memorial Hospital, Inc. | 240 Shenandoah St, Woodstock, VA 22664-1051 |
| Erik Mitchell | Orthopedic Surgery | Valley Physician Enterprise, Inc | 240 Shenandoah St, Woodstock, VA 22664-1051 |
| Kevin J Barko | Physician Assistant | Shenandoah Memorial Hospital, Inc. | 240 Shenandoah St, Woodstock, VA 22664-1051 |
| Kelly A Botta | Physician Assistant | Shenandoah Memorial Hospital, Inc. | 240 Shenandoah St, Woodstock, VA 22664-1051 |
| Thomas M Cardwell | Psychiatry | Shenandoah Memorial Hospital, Inc. | 240 Shenandoah St, Woodstock, VA 22664-1051 |
| Melissa A Lafferty | Nurse Practitioner | Shenandoah Memorial Hospital, Inc. | 240 Shenandoah St, Woodstock, VA 22664-1051 |
| Barbara P Brennan | Nurse Practitioner | Shenandoah Memorial Hospital, Inc. | 240 Shenandoah St, Woodstock, VA 22664-1051 |
| John Charles Quinn | Cardiovascular Disease (cardiology) | Shenandoah Memorial Hospital, Inc. | 240 Shenandoah St, Woodstock, VA 22664-1051 |
| John Hoffman | Family Practice | Shenandoah Memorial Hospital, Inc. | 240 Shenandoah St, Woodstock, VA 22664-1051 |
| Donna T Van Horn | Clinical Social Worker | Shenandoah Memorial Hospital, Inc. | 240 Shenandoah St, Woodstock, VA 22664-1051 |
| Find all physicians in zip 22664 | |||
| City | WOODSTOCK |
| Zip Code | 22664 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | WOODSTOCK + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Gary W Wake.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.