Provider Demographics
NPI:1427085844
Name:WAYT, MATTHEW PAUL (PA-C)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PAUL
Last Name:WAYT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:245 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ORRVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44667-1768
Mailing Address - Country:US
Mailing Address - Phone:330-682-3075
Mailing Address - Fax:330-682-7454
Practice Address - Street 1:365 S CROWN HILL RD
Practice Address - Street 2:
Practice Address - City:ORRVILLE
Practice Address - State:OH
Practice Address - Zip Code:44667-9527
Practice Address - Country:US
Practice Address - Phone:330-682-3075
Practice Address - Fax:330-682-7454
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH2356363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant