Marc E Waitek, PA
Individual provider Active NPI Physician Assistant · Osage, IA
NPI 1821180431 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1821180431
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 000653 (IA)
- Practice address
- 620 N 8TH St
Osage, IA 50461-1456 - Phone
- (641) 732-6100
- Fax
- (641) 732-6108
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Floyd County Memorial Hospital Commission | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 000653 | IA | Yes |
Addresses
Primary practice location
620 N 8TH St
Osage, IA 50461-1456
Mailing address
621 S Illinois Ave
Suite 103
Mason City, IA 50401-5489
Phone (641) 494-3041
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3063842 | Medicaid | IA | |
| 48713 | Other | IA | WELLMARK |
Other providers in Osage, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.