Individual
DR. MELVIN D WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 12TH ST SE STE 110, SALEM, OR 97302-2153
(503) 364-3704
(503) 399-9722
Mailing address
PO BOX 3437, SALEM, OR 97302-0437
(503) 269-9435
(503) 385-8554
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD14645
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1040088
—
WA
05
—
176172
—
OR
05
—
500762075
—
OR
01
—
P00117971
RR MEDICARE
OR
Enumeration date
08/05/2006
Last updated
06/12/2019
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