Individual
TERRY S WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
255 S GRAND MESA DR, CEDAREDGE, CO 81413-3822
(970) 856-4111
(970) 856-4114
Mailing address
255 S GRAND MESA DR, CEDAREDGE, CO 81413-3822
(970) 856-4111
(970) 856-4114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32008
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01320084
—
CO
01
—
080120285
RAILROAD MEDICARE
CO
01
—
119646
SELECT NET PINNACOL WC
CO
01
—
1364
BLUE CROSS NASCO
—
01
—
1421447
FIRST HEALTH
CO
01
—
1721506
CIGNA
CO
01
—
39326
CO BLUE CROSS
CO
01
—
4087979
BLUE CROSS
TN
01
—
4361601
AETNA
CO
01
—
4703170001
DMERC SUPPLIER
CO
01
—
841452365002
ROCKY MOUNTAIN HEALTH PLA
CO
Enumeration date
05/23/2005
Last updated
11/01/2022
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