Individual
STEPHEN B WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10406862
—
VA
01
—
142R9
BCBS
—
01
—
190074
MEDCOST
—
01
—
2058779
MEDICARE
NC
05
—
3810008047
—
WV
05
—
5904590
—
NC
01
—
7318833
AETNA
—
01
—
808510
PARTNERS
—
Enumeration date
07/11/2006
Last updated
02/15/2008
Update your record
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