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Individual

JOHN L WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
688 KINOOLE ST STE 103, HILO, HI 96720-3868
(808) 969-8010
(903) 663-7394
Mailing address
100 HOSPITAL DR, BENNINGTON, VT 05201-5004

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
FF0532689
VT
2085R0202X
Diagnostic Radiology Physician
Primary
MD20349
HI
2085R0202X
Diagnostic Radiology Physician
ME78473
FL

Other

Enumeration date
06/05/2006
Last updated
10/18/2019
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