Larry Dean Wadell in Maple Grove - Family Medicine
Larry Dean Wadell - NPI 1629174503
Larry Dean Wadell is a Family Medicine in Maple Grove, Minnesota. Larry Dean Wadell practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Larry Dean Wadell is 1629174503. The last update date is 2007-07-08.
Larry Dean Wadell's current location address is 7676 Mariner Dr, Maple Grove, Minnesota. You can contact this provider via phone number 7634949397 and fax number 7634945518. The mailing address for Larry Dean Wadell is 7676 Mariner Dr, Maple Grove, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Larry Dean Wadell |
|---|---|
| Address | 7676 Mariner Dr, Maple Grove, Minnesota |
| Phone Number | 7634949397 |
| Fax Number | 7634945518 |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1629174503 |
|---|---|
| Provider Enumeration Date | 2006-09-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 7676 Mariner Dr |
|---|---|
| City | Maple Grove |
| State | Minnesota (MN) |
| Post Code | 553112615 |
| Phone Number | 7634949397 |
| Fax Number | 7634945518 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 33713 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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What is the unique 10-digit identifier code assigned to Larry Dean Wadell by the Centers for Medicare & Medicaid Services?
The Larry Dean Wadell has been issued the NPI (National Provider Identifier) 1629174503 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the Larry Dean Wadell's physical address?
The Larry Dean Wadell is physically located at 7676 Mariner Dr, in the city of Maple Grove, MN, with the postal code 553112615.
What is the Larry Dean Wadell's specialty and taxonomy code?
The Larry Dean Wadell's specialty is Family Medicine, and the corresponding taxonomy code is 207Q00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1629174503 to Larry Dean Wadell?
The Larry Dean Wadell received its 1629174503 assignment from the Centers for Medicare & Medicaid Services on 2006-09-16.
As of what date were the Larry Dean Wadell's details last updated?
The information pertaining to the Larry Dean Wadell, including its address, specialty, and other details, was most recently updated on 2007-07-08.