DR. BRENDA WILLIS-WADE (NPI# 1902420573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902420573 |
| Entity Type | Individual |
| Full Name | DR. BRENDA WILLIS-WADE |
| Other Name | DR. BRENDA WILLIS |
| Credential | MD |
| Practice Address |
1600 Keswick Place Dr Lawrenceville GA 30043-6627 |
| Practice Telephone | 6787736270 |
| Mailing Telephone | 6787736270 |
| Enumeration Date | 2020-05-30 |
| Last Update Date | 2020-05-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 4301044144 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
1600 KESWICK PLACE DR |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30043-6627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609483882 | Brittany Javier Dunn | Counselor | 2387 Lawrenceville Huntcrest Way, Lawreneville, GA 30043 | 2020-09-30 |
| 1629614037 | Terrea Gina Bridges | Behavior Technician | 2387 Huntcrest Rd, Lawrenceville, GA 30043 | 2019-11-20 |
| 1215581756 | Elegant Lm Management, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1020 Meadowsong Circle, Lawrenceville, GA 30043 | 2019-08-01 |
| 1093299778 | Shareef Nahas | Clinical Medical Laboratory | 1130 Hurricane Shoals Rd, Suite 1800, Lawrenceville, GA 30043 | 2018-09-19 |
| 1649766874 | Nutritionecw LLC | Dietitian, Registered | 1755 North Brown Rd, Ste.200, Lawrenceville, GA 30043 | 2018-07-11 |
| 1962997965 | David Le Nguyen | Dentist | 2000 Riverside Pkwy Ste 200, Lawrenceville, GA 30043 | 2018-06-22 |
| 1932611688 | Asfc Outreach Therapeutic Counseling Services, LLC | Counselor | 1755 North Brown Road, Suite 200, Lawrenceville, GA 30043 | 2017-11-02 |
| 1518486810 | Shira Brey Williams | Specialist/Technologist | 1030 Collins Hill Rd, Lawrenceville, GA 30043 | 2017-09-18 |
| 1700300795 | Nympha J. Mathurin Meadows | Behavioral Analyst | 650 Oxford Crest Ct, Lawrenceville, GA 30043 | 2017-08-01 |
| 1992245591 | Jagruti Chaudhari | Nurse Practitioner | 855 Buford Drive, Lawrenceville, GA 30043 | 2017-03-01 |
| Find all providers in zip 30043 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780123588 | Feliks Shtindler Md PC | Internal Medicine | 3450 Princeton Pike, Suite 120, Lawrenceville, NJ 08648 | 2017-02-14 |
| 1902200835 | Odianosen I Obadan | Internal Medicine | 601 Professional Dr Ste 235a, Lawrenceville, GA 30046-7697 | 2014-10-21 |
| 1831416270 | Nidhip Anil Patel | Internal Medicine | 500 Medical Center Blvd Ste 310, Lawrenceville, GA 30046-3332 | 2010-04-26 |
| 1700108784 | North Atlanta Medical Clinic, L.l.c | Internal Medicine | 3664 Club Drive, Suite 201, Lawrenceville, GA 30044 | 2010-02-18 |
| 1932355294 | New Horizons Internal Medicine LLC | Internal Medicine | 771 Old Norcross Rd Ste 110, Lawrenceville, GA 30045-4317 | 2008-08-18 |
| 1376704106 | Samuel Deutsch Md PC | Internal Medicine | 316 W Pike St Ste 100, Lawrenceville, GA 30045-4878 | 2008-06-24 |
| 1033385877 | Neel Jitendra Gandhi | Internal Medicine | 2997 Princeton Pike, #201, Lawrenceville, NJ 08648 | 2008-05-01 |
| 1184899510 | Edward Joseph Ostrowski | Internal Medicine | 276 Fieldboro Dr, Lawrenceville, NJ 08648-3914 | 2008-04-27 |
| 1376717504 | Victorine Mafoueka Nguena | Internal Medicine | 3664 Club Dr Ste 201, Lawrenceville, GA 30044-2959 | 2008-04-18 |
| 1619166717 | Gwinnett Family Medicine | Internal Medicine | 510 Grayson Hwy, Lawrenceville, GA 30045-6332 | 2007-10-15 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30043 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.