Individual
DR. THOMAS JOHN WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 DELAFIELD ST, SUITE 209, WAUKESHA, WI 53188-3403
(262) 542-0444
(262) 542-8214
Mailing address
1111 DELAFIELD ST, SUITE 209, WAUKESHA, WI 53188-3403
(262) 542-0444
(262) 542-8214
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
54124-20
WI
2086S0129X
Vascular Surgery Physician
54124-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366615718
—
WI
Enumeration date
04/08/2008
Last updated
04/24/2019
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