Healthcare Provider Details

I. General information

NPI: 1801761432
Provider Name (Legal Business Name): CARTER WESCOTT WADE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7256 LAVENDER LN
LEWIS CENTER OH
43035-8147
US

IV. Provider business mailing address

7256 LAVENDER LN
LEWIS CENTER OH
43035-8147
US

V. Phone/Fax

Practice location:
  • Phone: 614-674-0559
  • Fax:
Mailing address:
  • Phone: 614-674-0559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberVL235447
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: