Provider Demographics
NPI:1376643254
Name:CARTWRIGHT, WADE R (MD)
Entity Type:Individual
Prefix:
First Name:WADE
Middle Name:R
Last Name:CARTWRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 30TH ST
Mailing Address - Street 2:# 401
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3301
Mailing Address - Country:US
Mailing Address - Phone:510-834-6642
Mailing Address - Fax:510-834-3115
Practice Address - Street 1:411 30TH ST
Practice Address - Street 2:# 401
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3301
Practice Address - Country:US
Practice Address - Phone:510-834-6642
Practice Address - Fax:510-834-3115
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG262211207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A42945Medicare UPIN
00G262211Medicare PIN