Individual
DR. SHAWN ALAN WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 S 16TH ST, LINCOLN, NE 68502-3704
(402) 475-1011
Mailing address
2300 S 16TH ST, LINCOLN, NE 68502-3704
(402) 475-1011
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25070
NE
207P00000X
Emergency Medicine Physician
38264
IA
207P00000X
Emergency Medicine Physician
941108
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780807438
—
IA
Enumeration date
04/11/2007
Last updated
11/06/2011
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