Individual
ROBERT W WAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6555 QUINCE RD, MEMPHIS, TN 38119-8202
(901) 515-5704
(901) 515-5729
Mailing address
877 JEFFERSON AVE, ATTN: PROVIDER ENROLLMENT, MEMPHIS, TN 38103-2807
(901) 545-7302
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
17572
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00010307
—
MS
05
—
117837001
—
AR
01
—
4355718
BCBS
TN
01
—
P01245913
RAILROAD MEDICARE
TN
05
—
Q002427
—
TN
Enumeration date
05/01/2006
Last updated
03/03/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us