Individual
WADE FORNANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4600 VALLEY RD, LINCOLN, NE 68510-4855
(402) 483-4571
(308) 344-8369
Mailing address
1401 E H ST, MC COOK, NE 69001-3432
(308) 344-4110
(308) 344-8369
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22563
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470748011-12
—
NE
Enumeration date
02/07/2006
Last updated
04/21/2021
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