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NPI Code Detail

MEDICARE: WADE JOEL OTRUBA M.D.

MEDICARE: WADE JOEL OTRUBA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianMD22605ME

General Provider Information

NPI Number : 1942599840
Entity Type Code : Individual
Provider Name (Legal Business Name) : WADE JOEL OTRUBA M.D.
Provider Business Mailing Address
First Line : 43 WHITING HILL RD
Second Line :
City : BREWER
State : ME
Zip : 04412-1005
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 489 STATE ST
Second Line :
City : BANGOR
State : ME
Zip : 04401-6616
Country : US
Telephone Number : 207-275-0987
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2011
Last Update Date : 03/03/2026

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