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General NPI Number Information
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NPI Number | 1487984027
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Entity Type | Individual
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Provider Name | MATTHEW WADE EARLY MD
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Gender | Male
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Dates
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Enumeration Date | 01/04/2010
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Last Update Date | 09/29/2024
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Provider Practice Location Address
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Address Line | NAVY MEDICINE OPERATIONAL TRAINING COMMAND (NMOTC) 220 HOVEY RD. BLDG 664
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City | PENSACOLA
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State | FL
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Zip | 32508
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Country | US
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Telephone | 850-452-9484
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Fax | 850-452-3842
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Provider Business Mailing Address
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Address Line | NMOTC 220 HOVEY RD.
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City | PENSACOLA
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State | FL
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Zip | 32508
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Country | US
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Telephone |
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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 | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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