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Individual

MICHAEL DAVID WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A. - C

Contact information

Practice address
799 E HAMPDEN AVE, #400, ENGLEWOOD, CO 80113-2700
(303) 789-2663
(303) 788-4871
Mailing address
4900 S MONACO ST, #210, DENVER, CO 80237-3486
(303) 789-2663
(303) 788-4871

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4192
CO
363AS0400X
Surgical Physician Assistant
085.003259
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07535759
CO
Enumeration date
08/13/2008
Last updated
02/10/2022
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