Individual ProviderMichael WyngardenAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address100 Brewster Blvd, Camp Lejeune, NC 28547-2575(910) 450-4357PECOS EnrollmentBased on the most recent information from CMS, provider Michael Wyngarden is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1568965838Provider TypeIndividualFull NameWyngarden, MichaelTitleDr.CredentialDOGenderMaleSole ProprietorYesEnumeration Date3/13/2018Last Updated7/16/2025Contact InformationPractice LocationPractice Address100 Brewster Blvd, Camp Lejeune, NC 28547-2575Phone(910) 450-4357FaxUnlisted FaxMailing LocationMailing Address100 Brewster Blvd, Camp Lejeune, NC 28547-2575PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicense0102205754VirginiaCode171000000XDescriptionMilitary Health Care ProviderOther Service ProvidersLicense0102205754VirginiaCode207L00000XDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicense2024-03203North Carolina