Individual
TADAIE WAKAMATSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 N CLAYTON ST, SUITE 601, WILMINGTON, DE 19805-3165
(302) 652-6050
(302) 652-6053
Mailing address
PO BOX 8157, WILMINGTON, DE 19803-8157
(302) 652-6032
(302) 652-6053
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C1-0000899
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000038101
—
DE
Enumeration date
07/08/2005
Last updated
11/17/2008
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