Healthcare Provider Details

I. General information

NPI: 1891855615
Provider Name (Legal Business Name): WADE F EXUM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19531 MCLANE ST SUITE B
PALM SPRINGS CA
92262
US

IV. Provider business mailing address

2197 PLUMAS ST
RENO NV
89509-3711
US

V. Phone/Fax

Practice location:
  • Phone: 951-358-4501
  • Fax:
Mailing address:
  • Phone: 702-497-8202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC40240
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: