Individual
COLEMAN WADE DAVIDSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
13613
TN
207VX0000X
Obstetrics Physician
Primary
53209
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254811
—
AZ
01
—
53209
AZ STATE LICENSE
AZ
Enumeration date
05/23/2005
Last updated
09/13/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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