Individual
ELLIOT LOUIS WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6970 W PATRICK LN, SUITE 140, LAS VEGAS, NV 89113-0269
(702) 450-1717
Mailing address
3022 S DURANGO DR, SUITE 100, LAS VEGAS, NV 89117-4439
(702) 450-1717
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12770
NV
207R00000X
Internal Medicine Physician
A97317
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487810321
—
NV
Enumeration date
07/30/2008
Last updated
02/22/2010
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