Provider Demographics
NPI:1427165356
Name:ABERLE, WAYNE D (OD)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:D
Last Name:ABERLE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2346 ROLLING DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-3024
Mailing Address - Country:US
Mailing Address - Phone:701-527-3783
Mailing Address - Fax:701-663-1604
Practice Address - Street 1:2304 CLYDESDALE DR
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0947
Practice Address - Country:US
Practice Address - Phone:701-255-2865
Practice Address - Fax:701-255-0443
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND587152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND60540Medicaid
ND24012Medicare ID - Type Unspecified
ND60540Medicaid
ND5291240001Medicare NSC