MEDICARE: WADE H MELVIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME 42465	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	32072	OTHER	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689627887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WADE H MELVIN MD

Provider Business Mailing Address
First Line	:	403 E 11TH ST STE 4
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32401-3409
Country	:	US
Telephone Number	:	850-767-3350
Fax Number	:	850-767-3353

Provider Business Practice Location Address
First Line	:	1440 MAIN ST
Second Line	:
City	:	CHIPLEY
State	:	FL
Zip	:	32428-6943
Country	:	US
Telephone Number	:	850-676-4926
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	06/02/2026

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