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General NPI Number Information
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NPI Number | 1518160837
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Entity Type | Organization
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Legal Business Name | JAMES SCOTT WREDE, D.O., LLC
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 12/30/2008
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Provider Practice Location Address
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Address Line | 109A COUNTY RD
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City | NORTH FALMOUTH
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State | MA
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Zip | 02556-2019
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Country | US
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Telephone | 508-564-6262
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Fax | 508-564-6204
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Provider Business Mailing Address
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Address Line | 109A COUNTY RD
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City | NORTH FALMOUTH
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State | MA
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Zip | 02556-2019
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Country | US
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Telephone | 508-564-6262
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Fax | 508-564-6204
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Authorized Official
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Title or Position | PRESIDENT PHYSICIAN
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Name | DR. JAMES SCOTT WREDE
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Credential | D. O.
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Telephone | 508-564-6262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 158481
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License Number State | MA
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