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Individual

SAM WADE WADHVANIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5121 S COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-4384
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD 420995
PA
208M00000X
Hospitalist Physician
Primary
6405008-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1009459080001
PA
Enumeration date
07/06/2005
Last updated
01/29/2026
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