Individual
WADE A STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7330
Mailing address
3605 WARRENSVILLE CENTER RD, 1ST FLOOR, SHAKER HTS, OH 44122-5203
(216) 286-6260
(216) 286-6341
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
COA08487NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221264
UNISON
OH
01
—
000000516012
ANTHEM
OH
01
—
0583328
BCMH
OH
05
—
2608306
—
OH
01
—
415038
WELLCARE MEDICAID
OH
01
—
751015
BUCKEYE MEDICAID
OH
01
—
7952914
AETNA
OH
01
—
P00880298
RAILROAD MEDICARE
OH
Enumeration date
07/28/2006
Last updated
02/15/2011
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