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NPI Code Detail

MEDICARE: LEVI DAVID WADE

MEDICARE: LEVI DAVID WADE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1952971830
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEVI DAVID WADE
Provider Business Mailing Address
First Line : 1315 10TH ST SW
Second Line :
City : MOUNT VERNON
State : IA
Zip : 52314-9577
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2301 HUDSON RD
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50614-0012
Country : US
Telephone Number : 319-273-6275
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2021
Last Update Date : 07/01/2021

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Directions to “ LEVI DAVID WADE ” Practice Location

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