Individual
MARK RICHARD WAKEFIELD
Active
Individual
MARK RICHARD WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
106072
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209289404
—
MO
01
—
P00147243
RR MEDICARE
MO
01
—
P00415790
RAILROAD MEDICARE
MO
Enumeration date
05/25/2006
Last updated
05/20/2024
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