Wybenga, Maarten A

Wybenga, Maarten A is an individual health care provider with primary practice located at 645 Mcqueen Smith Rd N Ste 309 , Prattville AL 36066-7269. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wybenga, Maarten A can be contacted via phone (334) 358-2010.

Contact Information

Primary practice address
645 Mcqueen Smith Rd N Ste 309 Prattville AL 36066-7269
Phone: (334) 358-2010
Fax: (334) 358-2013
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 13662 Alabama

Profile Details

NPI number 1902987555
LBN Legal business name Wybenga, Maarten A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Jan 5th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902987555 NPPES
Alabama Other 51515040 BLUE CROSS
Alabama MEDICAID 051515040 BLUE CROSS

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