Provider Demographics
NPI:1861554172
Name:SENFT, WAYNE HAROLD (DO)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:HAROLD
Last Name:SENFT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 THIRD ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331
Mailing Address - Country:US
Mailing Address - Phone:717-637-6162
Mailing Address - Fax:717-637-2507
Practice Address - Street 1:212 THIRD ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331
Practice Address - Country:US
Practice Address - Phone:717-637-6162
Practice Address - Fax:717-637-2507
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003005L208000000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
D77459Medicare UPIN
PA112579Medicare ID - Type Unspecified