Wade, Mark Alan

Wade, Mark Alan is an sole proprietor health care provider with primary practice located at 2310 Peger Rd Ste 105, Fairbanks AK 99709-5315. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Wade, Mark Alan can be contacted via phone (907) 479-2663.

Contact Information

Primary practice address
2310 Peger Rd Ste 105 Fairbanks AK 99709-5315
Phone: (907) 479-2663
Fax: (907) 479-2691
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 4018 Alaska
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 4018 Alaska

Profile Details

NPI number 1356307458
LBN Legal business name Wade, Mark Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 26th, 2006
Last updated Apr 18th, 2013 - about 11 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 1356307458 NPPES
Alaska MEDICAID MD07391
Alaska Other 194028200
Alaska MEDICAID MD07392
Alaska MEDICAID MD6149

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