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Individual

DR. MATTHEW A WAKELEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1 MEDICAL CENTER BLVD, UPLAND, PA 19013
(609) 501-4040
Mailing address
604 APPLE DR, MULLICA HILL, NJ 08062-9476
(609) 501-4040

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
25MB07749100
NJ
207P00000X
Emergency Medicine Physician
Primary
OS-010326-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0048038
NJ
Enumeration date
09/16/2005
Last updated
06/25/2009
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