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Individual

MATTHEW JOEL WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2520 5TH ST N, COLUMBUS, MS 39705-2008
(662) 244-2042
(662) 244-2041
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5827

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20337
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08807834
MS
Enumeration date
07/31/2008
Last updated
10/24/2016
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