Individual
ROBERT KEATH WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 DARLING AVE, WAYCROSS, GA 31501-5246
(912) 261-2669
(912) 261-0561
Mailing address
PO BOX 30309, CHARLESTON, SC 29417-0309
(846) 554-9300
(843) 566-8781
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
055575
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275098800
—
FL
05
—
324421953A
—
GA
05
—
791600810
—
GA
Enumeration date
09/07/2005
Last updated
04/29/2008
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