Ryan Wade, MD | |
2015 2nd Ave Ste 101, Summerville, SC 29486-7889 | |
(843) 737-9465 | |
Not Available |
Full Name | Ryan Wade |
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Gender | Male |
Speciality | Pediatrics |
Location | 2015 2nd Ave Ste 101, Summerville, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1528473469 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208000000X | Pediatrics | 2017-01215 (North Carolina) | Secondary |
208000000X | Pediatrics | 86509 (South Carolina) | Primary |
Entity Name | Dlp Western Carolina Physician Practices Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609281641 PECOS PAC ID: 9032338975 Enrollment ID: O20140908002531 |
Mailing Address | Practice Location Address |
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Ryan Wade, MD 2067 Charlie Hall Blvd, Charleston, SC 29414-5834 Ph: (843) 573-2535 | Ryan Wade, MD 2015 2nd Ave Ste 101, Summerville, SC 29486-7889 Ph: (843) 737-9465 |
Dr. Esther Spiegle Wilson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 202 Bentons Lodge Rd, Summerville, SC 29485 Phone: 843-871-2588 | |
Dr. Emily Kathleen Johnson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2016 1st Ave, Summerville, SC 29486 Phone: 843-873-4545 Fax: 843-873-1561 | |
Mr. Benjamin L Rodgers, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 748 Orangeburg Rd, Summerville, SC 29483 Phone: 843-832-8606 Fax: 843-285-7272 | |
Mr. Mark Jeffrey Mccall, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 312 Midland Pkwy, Summerville, SC 29485 Phone: 843-875-6262 Fax: 843-873-7958 | |
Mr. John William Pence Sr., MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1815 Old Trolley Rd, Summerville, SC 29485 Phone: 843-875-0440 Fax: 843-875-0442 | |
Seth Winkler, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 312 Midland Pkwy, Summerville, SC 29485 Phone: 843-875-6262 | |
Dr. Shanika Damien Rutledge, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2015 2nd Ave Ste 101, Summerville, SC 29486 Phone: 843-573-2535 Fax: 843-573-2534 |