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General NPI Number Information
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NPI Number | 1154309334
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Entity Type | Individual
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Provider Name | ROBERT C WADE MD
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Gender | Male
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 1705 EAST THIRD STREET
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City | FARMVILLE
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State | VA
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Zip | 23901-1199
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Country | US
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Telephone | 434-315-2998
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Fax | 434-315-2859
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Provider Business Mailing Address
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Address Line | 2010 ATHERHOLT RD
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City | LYNCHBURG
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State | VA
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Zip | 24501-1106
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0102050072
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License Number State | VA
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