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Individual
MR. MARVIN SCOTT WADE
Active
Individual
MR. MARVIN SCOTT WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1057840
—
363A00000X
Physician Assistant
Primary
2091
SC
Other
Enumeration date
11/08/2005
Last updated
06/24/2016
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