Wade, George A.

Wade, George A. is an individual health care provider with primary practice located at 1188 University Dr , Boise ID 83706-3009. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Wade, George A. can be contacted via phone (208) 336-8250.

Contact Information

Primary practice address
1188 University Dr Boise ID 83706-3009
Phone: (208) 336-8250
Fax: (208) 345-9514
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X M3813 Idaho

Profile Details

NPI number 1063418903
LBN Legal business name Wade, George A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2005
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063418903 NPPES
Idaho Other 000010005427 REGENCE BLUE SHIELD #
Idaho Other 38133 REGENCE BLUE SHIELD #

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