Individual provider · Type 1 NPI

Justin Richard Waite

Surgical Physician Assistant · Columbia, MD

NPI number 1003203845 Active

Practice location

5900 Cedar Ln
Columbia, MD 21044-3635

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XC0005749 (MD)

Surgical Physician Assistant: Definition to come...

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About NPI 1003203845

Justin Richard Waite's National Provider Identifier is 1003203845, issued on Apr 20, 2015. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Columbia, MD. The record was last updated on Mar 22, 2018.