Individual
JOHN WAIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 W MAIN ST, CUBA, NY 14727-1317
(585) 968-3877
Mailing address
9275 COUNTY ROAD 46, ARKPORT, NY 14807-9484
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
008982-1
NY
363AM0700X
Medical Physician Assistant
8982
NY
Other
Enumeration date
11/19/2005
Last updated
07/03/2023
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