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NPI Code Detail

MEDICARE: DEBRA SZOSTAK-WODECKI MD

MEDICARE: DEBRA SZOSTAK-WODECKI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician9300336NC
2207RG0300XGeriatric Medicine (Internal Medicine) Physician9300336NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598760407
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA SZOSTAK-WODECKI MD
Provider Business Mailing Address
First Line : 293 OLD MOCKSVILLE RD
Second Line :
City : STATESVILLE
State : NC
Zip : 28625-1930
Country : US
Telephone Number : 704-872-8711
Fax Number : 704-872-5866
Provider Business Practice Location Address
First Line : 293 OLD MOCKSVILLE RD
Second Line :
City : STATESVILLE
State : NC
Zip : 28625-1930
Country : US
Telephone Number : 704-872-8711
Fax Number : 704-872-5866
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 08/28/2023

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