DR. MICHAEL WYNGARDEN (NPI# 1568965838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568965838 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL WYNGARDEN |
| Credential | DO |
| Practice Address |
2d Marine Division Camp Lejeune NC 28542 |
| Mailing Address |
213 Sandfiddler E Emerald Isle NC 28594-2284 |
| Practice Telephone | 9104518155 |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2019-10-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care | ||
| Y | 171000000X | Military Health Care Provider | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 620 John Paul Jones Cir, Portsmouth, VA 237082111 | 7579535000 |
| Street Address |
2D MARINE DIVISION |
| City | CAMP LEJEUNE |
| State | NC |
| Zip Code | 28542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730794439 | Lauren Marie Barton | Dentist | H M Smith Blvd, Bldg Fc-308, Camp Lejeune, NC 28542 | 2020-09-10 |
| 1003444928 | Andres Martin Rodoni | Military Health Care Provider | 2nd Reconnaissance Battalion, Camp Lejune, NC 28542 | 2020-03-27 |
| 1699306670 | Dominick Ciampo | Military Health Care Provider | A66 Boat Basin Road, Camp Lejeune, NC 28542 | 2020-01-29 |
| 1881243525 | Alexander Thomas Rodgers | Military Health Care Provider | 2nd Raider Battalion, A66 Boat Basin Rd, Camp Lejeune, NC 28542 | 2019-09-05 |
| 1992352454 | Kirsten Janel Snow | Physician Assistant | Hm Smith Boulevard, Bldg Fc-308, Camp Lejeune, NC 28542 | 2019-08-20 |
| 1639735947 | Cody Robert Patton | Military Health Care Provider | 3rd Marine Raider Battalion, Bldg 614, Camp Lejeune, Nc, NC 28542 | 2019-05-13 |
| 1558832345 | Nathaniel Franklin Campbell | Military Health Care Provider | Rr 612 Everett Creek Rd, Camp Lejuene, Fpo, AE 28542 | 2018-12-06 |
| 1578032504 | Brendon Earl Dumas | Military Health Care Provider | Rr612 Everett Creek Road, Camp Lejeune, NC 28542 | 2018-11-20 |
| 1053896514 | Roy Atallah | Military Health Care Provider | 2nd Marine Raider Battalion, Camp Lejeune, NC 28542 | 2018-10-01 |
| 1316422975 | Zachary Thomas Monahan | General Practice | Hm Smith Boulevard Bldg Fc-308, Camp Lejeune, NC 28542 | 2018-09-30 |
| Find all providers in zip 28542 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699338442 | Amanda Leigh Jepsen | Military Health Care Provider | Naval Medical Center; 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2019-04-17 |
| 1326296641 | Scott Durham Mitcham | Military Health Care Provider | Command Drive, Building 328, Camp Lejeune, NC 28542 | 2008-08-28 |
| 1588284145 | Brett Michael Frazier | Military Health Care Provider | Naval Medical Center Camp Lejeune, 100 Brewster Boulevard, Camp Lejeune, NC 28547 | 2020-04-23 |
| 1467089565 | Philip Daniel Brewer | Military Health Care Provider | Naval Medical Center, 100 Brewster Blvd., Camp Lejeune, NC 28547 | 2020-03-26 |
| 1619523594 | Sarah Michele Anderson | Military Health Care Provider | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2019-08-15 |
| 1588122667 | Nathan Meier | Military Health Care Provider | Naval Medical Center, 100 Brewster Blvd., Camp Lejeune, NC 28547-2538 | 2019-03-07 |
| 1508354820 | Brooke Danielle Streett | Military Health Care Provider | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2018-04-23 |
| 1780171173 | Emily Makhlouf | Military Health Care Provider | Naval Hospital Camp Lejeune, 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2018-04-20 |
| 1841719390 | Kyle Hagan | Military Health Care Provider | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2017-09-15 |
| 1518348119 | Alexander Eye | Military Health Care Provider | Naval Medical Ctr, 100 Brewster Blvd, Camp Lejeune, NC 28460 | 2015-06-09 |
| Find all providers in CAMP LEJEUNE | ||||
| City | CAMP LEJEUNE |
| Zip Code | 28542 |
Please comment or provide details below to improve the information on DR. MICHAEL WYNGARDEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.