Healthcare Provider Details

I. General information

NPI: 1396097747
Provider Name (Legal Business Name): GEORGES CHRISTOPHE WOODBRIDGE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2012
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100
APO AE
09180-3100
US

IV. Provider business mailing address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100 BOX
APO AE
09180-3100
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-8120
  • Fax:
Mailing address:
  • Phone: 314-590-8120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9106907
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: