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Individual

ROBERT STEPHEN WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1118 MORNINGSIDE DR, SUITE A, PERRY, GA 31069-4948
(478) 988-2205
(478) 988-2201
Mailing address
233 N HOUSTON RD, SUITE 140-H, WARNER ROBINS, GA 31093-3074
(478) 923-3360
(478) 923-9977

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
031350
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00377836D
GA
Enumeration date
05/04/2006
Last updated
07/22/2008
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