Provider Demographics
NPI:1154054856
Name:WADE, DILLON JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:DILLON
Middle Name:JAMES
Last Name:WADE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7710 MERCY ROAD, SUITE 202
Mailing Address - Street 2:CU DEPARTMENT OF SURGERY
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124
Mailing Address - Country:US
Mailing Address - Phone:402-280-4669
Mailing Address - Fax:
Practice Address - Street 1:7710 MERCY ROAD, SUITE 202
Practice Address - Street 2:CU DEPARTMENT OF SURGERY
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124
Practice Address - Country:US
Practice Address - Phone:402-280-4669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE9418208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery