Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RX0202X | Medical Oncology | 44131 | WI |
Y | 207RX0202X | Medical Oncology | MD446909 | PA |
NPI | 1174574685 |
---|---|
Provider Name | Dr. James C Wade |
First Address | Danville, PA 17822-4903 |
Second Address | Wilkes-Barre, PA 18711-3486 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 04/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003000261K | HUMANA (01) | |
102762237 | (05) | PA |
34162000 | (05) | WI |
D73886 | (02) |