Provider Demographics
NPI:1407828387
Name:WADE, DAVID S (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:WADE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:935 PENNSYLVANIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20535-0001
Mailing Address - Country:US
Mailing Address - Phone:202-324-6839
Mailing Address - Fax:202-324-0918
Practice Address - Street 1:935 PENNSYLVANIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20535-0001
Practice Address - Country:US
Practice Address - Phone:202-324-6839
Practice Address - Fax:202-324-0918
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2009-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010375272086X0206X
TXH56452086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN