Individual
MATTHEW WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4315 DIPLOMACY DR, ANCHORAGE, AK 99508-5926
(575) 302-7714
Mailing address
8630 ANGE ST UNIT A, ANCHORAGE, AK 99515-1519
(575) 302-7714
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
134693
AK
Other
Enumeration date
01/13/2020
Last updated
01/13/2020
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