Mark D Wade (NPI# 1376512137, PAC ID# 8527043868) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1376512137 |
| PAC ID by PECOS | 8527043868 |
| Professional Enrollment ID | I20101105000548 |
| Full Name | Mark D Wade |
| Organization Legal Name | NU-CROWN, LLC |
| Address |
10465 Saint Charles Rock Rd Saint Ann MO 63074-1829 |
| Phone Number | 3144232010 |
| Gender | M |
| Credential | OD |
| Medical School | ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO |
| Graduation Year | 1991 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 1456256346 |
| Number of Group Practice Members | 24 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 10465 Saint Charles Rock Rd, Saint Ann, MO 63074-1829 | 3144232010 | NU-CROWN, LLC |
| 4145 Lindell Blvd, Saint Louis, MO 63108-2913 | 3145331898 | NU-CROWN, LLC |
| Organization Legal Name | NU-CROWN, LLC |
| Physicians | 23 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christina J Levi | Optometry | Nu-crown, LLC | 406 E Broadway, Alton, IL 62002-2417 |
| Alexa S Kojima | Optometry | Nu-crown, LLC | 8885 Ladue Rd, Saint Louis, MO 63124-2088 |
| Charles M Lutz | Optometry | Nu-crown, LLC | 935 N Hwy 67 N, Florissant, MO 63031-2917 |
| Howard N Short | Ophthalmology | Nu-crown, LLC | 4145 Lindell Blvd, Saint Louis, MO 63108-2913 |
| Eneida Resuli | Optometry | Nu-crown, LLC | 427 Lafayette Ctr, Ballwin, MO 63011-3943 |
| Traci L Hahn | Optometry | Nu-crown, LLC | 10465 Saint Charles Rock Rd, Saint Ann, MO 63074-1829 |
| Matthew J Woodyard | Optometry | Nu-crown, LLC | 4145 Lindell Blvd, Saint Louis, MO 63108-2913 |
| Vinh Q Nguyen | Optometry | Nu-crown, LLC | 4145 Lindell Blvd, Saint Louis, MO 63108-2913 |
| Emily C O'brien | Optometry | Nu-crown, LLC | 4145 Lindell Blvd, Saint Louis, MO 63108-2913 |
| Mary C Hohenberger | Optometry | Nu-crown, LLC | 4145 Lindell Blvd, Saint Louis, MO 63108-2913 |
| Street Address |
10465 SAINT CHARLES ROCK RD |
| City | SAINT ANN |
| State | MO |
| Zip | 63074-1829 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Traci L Hahn | Optometry | Nu-crown, LLC | 10465 Saint Charles Rock Rd, Saint Ann, MO 63074-1829 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher T Labonte | Internal Medicine | Christopher T Labonte Md LLC | 10441 International Plaza Dr, Saint Ann, MO 63074-1805 |
| Eric S Baggstrom | Internal Medicine | Christopher T Labonte Md LLC | 10441 International Plaza Dr, Saint Ann, MO 63074-1805 |
| Stephen E Mullen | Optometry | Professional Eye Care Inc | 10441 International Plaza Dr, Saint Ann, MO 63074-1805 |
| Hillard K Cohen | Internal Medicine | Hillard K Cohen Inc | 500 Nw Plaza Dr, Suite 417, Saint Ann, MO 63074-2219 |
| City | SAINT ANN |
| Zip Code | 63074 |
| Specialty | OPTOMETRY |
| City + Specialty | SAINT ANN + OPTOMETRY |
Please comment or provide details below to improve the information on Mark D Wade.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.