Individual
ANNE C WADHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3200 WALFORD AVE, EUREKA, CA 95503-4828
(707) 445-3443
Mailing address
3200 WALFORD AVE, EUREKA, CA 95503-4828
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
12822
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
YYY49032Y
—
CA
Enumeration date
04/19/2006
Last updated
11/16/2021
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