Individual
DR. WADE ARON BANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1356 LUSITANA ST FL 6, HONOLULU, HI 96813-2409
(602) 344-5011
Mailing address
1356 LUSITANA ST FL 6, HONOLULU, HI 96813-2409
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MDR-8428
HI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2021
Last updated
11/07/2022
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