Provider Demographics
NPI:1710095286
Name:ANUNSON, WADE E (DC)
Entity Type:Individual
Prefix:DR
First Name:WADE
Middle Name:E
Last Name:ANUNSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 PLAZA DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-3871
Mailing Address - Country:US
Mailing Address - Phone:608-829-2250
Mailing Address - Fax:608-829-2251
Practice Address - Street 1:8215 PLAZA DR
Practice Address - Street 2:SUITE B
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-3871
Practice Address - Country:US
Practice Address - Phone:608-829-2250
Practice Address - Fax:608-829-2251
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3078-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI204430193013OtherBLUE CROSS BLUE SHIELD
WIU50661Medicare UPIN
WI000035856Medicare ID - Type Unspecified