Individual
GARY L WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2422 20TH ST SW, JAMESTOWN, ND 58401-6201
(701) 952-4854
Mailing address
484 SNIDER DR, WALLA WALLA, WA 99362-8075
(530) 340-1428
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD00022330
WA
Other
Enumeration date
09/23/2005
Last updated
08/13/2013
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