Individual
WADE METRO
Active
Individual
WADE METRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA05757600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02817256
—
NY
01
—
050070854
RAILROAD MEDICARE
NJ
05
—
9095608
—
NJ
Enumeration date
05/15/2006
Last updated
08/18/2011
Update your record
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