Healthcare Provider Details

I. General information

NPI: 1679135669
Provider Name (Legal Business Name): ANDREW WADE DANIEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ARH LN
LOW MOOR VA
24457-5702
US

IV. Provider business mailing address

1100 COMANCHE TRL
COVINGTON VA
24426-6920
US

V. Phone/Fax

Practice location:
  • Phone: 540-862-6294
  • Fax:
Mailing address:
  • Phone: 540-620-0093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101280314
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number70814
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: