Individual
ROBERT W WAKE
Active
Individual
ROBERT W WAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
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