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NPI Code Detail

MEDICARE: SEABORN MCDONALD WADE III M.D.

MEDICARE: SEABORN MCDONALD WADE III M.D.
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
1207RH0003XHematology & Oncology Physician0101234527VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2C01120OTHERVAMEDICARE GROUP PTAN
3P00431656OTHERVARR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4300980OTHERVAANTHEM BCBS

General Provider Information

NPI Number : 1265566772
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEABORN MCDONALD WADE III M.D.
Provider Business Mailing Address
First Line : 7202 GLEN FOREST DR
Second Line : SUITE 200
City : RICHMOND
State : VA
Zip : 23226-3781
Country : US
Telephone Number : 804-673-0134
Fax Number : 804-673-1796
Provider Business Practice Location Address
First Line : 7501 RIGHT FLANK RD
Second Line : SUITE 600
City : MECHANICSVILLE
State : VA
Zip : 23116-3863
Country : US
Telephone Number : 804-559-2489
Fax Number : 804-730-5847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 05/24/2021

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