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General NPI Number Information
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NPI Number | 1881644011
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Entity Type | Organization
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Legal Business Name | WOODBRIDGE MEDICAL GROUP, P.A
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 270 MAIN ST
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-1927
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Country | US
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Telephone | 732-636-5252
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Fax | 732-636-5452
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Provider Business Mailing Address
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Address Line | 270 MAIN ST
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-1927
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Country | US
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Telephone | 732-636-5252
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Fax | 732-636-5452
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT D BOYD
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Credential | D. O
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Telephone | 732-636-5252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MB30335
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License Number State | NJ
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