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General NPI Number Information
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NPI Number | 1083669600
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Entity Type | Individual
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Provider Name | GEORGE FREDRIK GADE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 1717 N E ST STE 422
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City | PENSACOLA
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State | FL
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Zip | 32501-6333
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Country | US
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Telephone | 850-469-0642
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Fax |
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Provider Business Mailing Address
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Address Line | 553 SEAWARD RD
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City | CORONA DEL MAR
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State | CA
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Zip | 92625-2600
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Country | US
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Telephone | 509-494-9753
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | MD60027817
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | G32809
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | ME88858
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License Number State | FL
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