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General NPI Number Information
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NPI Number | 1114925864
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Entity Type | Individual
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Provider Name | NANCY JANE WADE MD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 04/01/2021
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Provider Practice Location Address
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Address Line | 6190 HOSPITAL DR
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City | CASS CITY
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State | MI
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Zip | 48726-1072
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Country | US
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Telephone | 989-872-8503
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Fax | 989-872-1546
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Provider Business Mailing Address
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Address Line | 6190 HOSPITAL DR
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City | CASS CITY
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State | MI
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Zip | 48726-1072
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Country | US
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Telephone | 989-872-8503
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Fax | 989-872-1546
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | NW076446
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301076446
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License Number State | MI
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