Individual
DR. ELIZABETH HOWARD WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7926 PRESTON HWY STE 106, LOUISVILLE, KY 40219-3848
(502) 964-4357
(502) 966-5948
Mailing address
PO BOX 776351, CHICAGO, IL 60677-1820
(502) 588-9490
(502) 721-8670
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18062
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000050234
ANTHEM
KY
01
—
1049804
PASSPORT
KY
01
—
1049813
PASSPORT
KY
01
—
1050067
PASSPORT
KY
01
—
1072555
PASSPORT
KY
01
—
1072559
PASSPORT
KY
05
—
300011728
—
IN
05
—
64180623
—
KY
01
—
K221580
MEDICARE
KY
Enumeration date
02/13/2007
Last updated
02/09/2023
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