Healthcare Provider Details

I. General information

NPI: 1780908277
Provider Name (Legal Business Name): JULI-ANNE C. WADE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2010
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 BEAM LN STE 202
FISHERSVILLE VA
22939-2350
US

IV. Provider business mailing address

PO BOX 749112
ATLANTA GA
30374-9112
US

V. Phone/Fax

Practice location:
  • Phone: 540-932-0980
  • Fax: 540-932-0979
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101253633
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: