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Individual
DR. GORDON FREDERICK WADGE
Active
Individual
DR. GORDON FREDERICK WADGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD.208087
LA
208M00000X
Hospitalist Physician
MD.208087
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06588588
—
MS
05
—
2196537
—
LA
Enumeration date
03/20/2012
Last updated
07/31/2019
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