Provider Demographics
NPI:1265566772
Name:WADE, SEABORN MCDONALD III (MD)
Entity type:Individual
Prefix:
First Name:SEABORN
Middle Name:MCDONALD
Last Name:WADE
Suffix:III
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7202 GLEN FOREST DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3781
Mailing Address - Country:US
Mailing Address - Phone:804-673-0134
Mailing Address - Fax:804-673-1796
Practice Address - Street 1:7501 RIGHT FLANK RD
Practice Address - Street 2:SUITE 600
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-3863
Practice Address - Country:US
Practice Address - Phone:804-559-2489
Practice Address - Fax:804-730-5847
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2021-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101234527207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1265566772Medicaid
VAC01120OtherMEDICARE GROUP PTAN
VAP00431656OtherRR MEDICARE
VA300980OtherANTHEM BCBS
VA014179V20Medicare PIN