Healthcare Provider Details

I. General information

NPI: 1053408708
Provider Name (Legal Business Name): MARCELLA RAE WOICZIK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 ALAMEDA AVE BLDG B
EL PASO TX
79905-2914
US

IV. Provider business mailing address

5201 CREEK STONE CT
PARK CITY UT
84098-5969
US

V. Phone/Fax

Practice location:
  • Phone: 915-242-8402
  • Fax: 915-242-8404
Mailing address:
  • Phone: 801-707-4071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number6583678-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberP1251
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: