Individual
DR. FREDIA STOVALL WADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 S HANSON ST, EASTON, MD 21601-2920
(410) 819-5606
(410) 819-4703
Mailing address
100 S HANSON ST, EASTON, MD 21601-2920
(410) 819-5606
(410) 819-4703
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
D0066574
MD
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M87082
STATE OF MARYLAND CDS NUMBER
MD
Enumeration date
07/08/2016
Last updated
07/08/2016
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