Wilde, Wade Wallace
Wilde, Wade Wallace is an individual health care provider with primary practice located at 1029 S Trimble Rd , Mansfield OH 44906-3427. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wilde, Wade Wallace can be contacted via phone (419) 521-2950.Contact Information
Primary practice address
1029 S Trimble Rd
Mansfield OH 44906-3427
Phone: (419) 521-2950
Fax: (419) 522-0837
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 18724 | Nebraska |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35.074229 | Ohio |
Profile Details
| NPI number | 1225017817 |
|---|---|
| LBN Legal business name | Wilde, Wade Wallace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 11th, 2006 |
| Last updated | Nov 23rd, 2020 - about 4 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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