Provider Demographics
NPI:1659581122
Name:WADEE, CHARLES FREMPONG (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:FREMPONG
Last Name:WADEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 EAST GREENVILLE STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-2049
Mailing Address - Country:US
Mailing Address - Phone:864-261-6000
Mailing Address - Fax:864-261-6947
Practice Address - Street 1:1403 EAST GREENVILLE STREET
Practice Address - Street 2:SUITE A
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-2049
Practice Address - Country:US
Practice Address - Phone:864-261-6000
Practice Address - Fax:864-261-6947
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18985207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT29779Medicaid
SCF70338Medicare UPIN