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General NPI Number Information
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NPI Number | 1497853550
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Entity Type | Individual
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Provider Name | PETER ARTHUR WOODBRIDGE MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1481 W 10TH ST ROUDEBUSH VA MEDICAL CENTER (11/AMB)
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City | INDIANAPOLIS
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State | IN
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Zip | 46202
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Country | US
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Telephone | 317-988-4163
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Fax |
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Provider Business Mailing Address
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Address Line | 4137 N MERIDIAN ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46208-4014
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Country | US
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Telephone | 317-924-2114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | G0584
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | 25132
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | 24263
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License Number State | AZ
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