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Individual
WADE E ANDERSON
Active
Individual
WADE E ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15034
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11179859
CAQH
NV
05
—
1571844
—
IA
05
—
1679559439
—
IA
05
—
1679559439
—
NV
05
—
2571844
—
IA
01
—
P001900008
RR MEDICARE
IA
Enumeration date
12/22/2005
Last updated
07/21/2022
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