Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | G32809 | CA |
N | 207T00000X | Neurosurgeon | MD60027817 | WA |
N | 207T00000X | Neurosurgeon | ME88858 | FL |
NPI | 1083669600 |
---|---|
Provider Name | Dr. George Fredrik Gade |
First Address | Corona Del Mar, CA 92625-2600 |
Second Address | Pensacola, FL 32501-6333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 16/02/2021 |