Individual
JUSTIN G WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
29520 CANVASBACK DR, EASTON, MD 21601-7124
(410) 822-5007
(410) 822-5569
Mailing address
8614 OCEAN GTWY, STE 4, EASTON, MD 21601-7217
(410) 690-8181
(410) 690-8185
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
D0066569
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259147-000
MAGELLAN
MD
01
—
346646
MHN
MD
01
—
517251
UBH
MD
01
—
522156095
COMMERCIAL INSURANCE
MD
05
—
609550001
—
MD
05
—
609550002
—
MD
05
—
609550004
—
MD
01
—
LM49EA
CAREFIRST BCBS
MD
01
—
R968
CAREFIRST BCBS-FEDERAL
MD
Enumeration date
11/01/2006
Last updated
08/28/2017
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