Wayne Starke Sr.

Individual provider Active NPI Driver · MC Kenney, VA

NPI 1154847812 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1154847812
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
Practice address
19718 Manson Church Rd
MC Kenney, VA 23872-2844
Phone
(804) 526-5820
NPI assigned
Aug 15, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X Yes

Addresses

Primary practice location

19718 Manson Church Rd
MC Kenney, VA 23872-2844

Mailing address

19718 Manson Church Rd
MC Kenney, VA 23872-2844
Phone (804) 526-5820

Other providers in MC Kenney, VA

All providers in MC Kenney, VA · Driver in Virginia

Sources for this page

Verify at the official NPI Registry.