Healthcare Provider Details

I. General information

NPI: 1447229133
Provider Name (Legal Business Name): RICHARD E.N. SEDWICK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1885 PORT REPUBLIC RD
HARRISONBURG VA
22801-3533
US

IV. Provider business mailing address

1885 PORT REPUBLIC RD
HARRISONBURG VA
22801-3533
US

V. Phone/Fax

Practice location:
  • Phone: 540-433-6613
  • Fax: 540-433-6605
Mailing address:
  • Phone: 540-433-6613
  • Fax: 540-433-6605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101029047
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: