Individual
DR. RONA LITA WADLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
33722 WOODWARD AVE, BIRMINGHAM, MI 48009-0912
(248) 919-4900
(248) 919-4901
Mailing address
1309 BIRD AVE, BIRMINGHAM, MI 48009-2049
(248) 644-4826
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5101013830
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114412950
—
MI
05
—
114412960
—
MI
01
—
RW013830
BC/BS OF MICHIGAN
MI
Enumeration date
05/28/2006
Last updated
12/01/2016
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