| Doctor Name: | DR. LYDIA M WADE |
| NPI Number: | 1992926893 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 4301086305 |
| Business Practice Address: | 1900 Centra Care Circle Centra Care Clinic - Women's & Childrens St Cloud, MN - 563035000 |
| Business Phone Number: | 3206543610 |
| Business Fax Number: | |
| Mailing Address: | 1900 Centra Care Circle, Centra Care Clinic - Women's & Childrens ST CLOUD |
| State: | MN |
| Postal Code: | 563035000 |
| Phone Number: | 3206543610 |
| Fax Number: | |
| NPI Enumeration Date: | 05/01/2007 |
| NPI Last Update Date: | 11/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | 4301086305 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |