Individual
DR. WILLIAM M. WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6170 N DURANGO DR STE 130, LAS VEGAS, NV 89149-3923
(702) 940-1550
(702) 940-1551
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10042
NV
207Q00000X
Family Medicine Physician
A84209
CA
207Q00000X
Family Medicine Physician
MD00036020
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A842090
—
CA
01
—
10042
STATE LICENSE
NV
05
—
1629017165
—
NV
Enumeration date
06/06/2006
Last updated
12/12/2022
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