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NPI Code Detail

MEDICARE: DAVID M WODICKA MD

MEDICARE: DAVID M WODICKA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0101036506VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080027740OTHERMEDICARE RAILROAD PROVIDER NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2065993OTHERANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982687125
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID M WODICKA MD
Provider Business Mailing Address
First Line : 2019 TATE SPRINGS RD
Second Line :
City : LYNCHBURG
State : VA
Zip : 24501-1111
Country : US
Telephone Number : 434-846-7374
Fax Number : 434-846-1910
Provider Business Practice Location Address
First Line : 2019 TATE SPRINGS RD
Second Line :
City : LYNCHBURG
State : VA
Zip : 24501-1111
Country : US
Telephone Number : 434-846-7374
Fax Number : 434-846-1910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 08/13/2013

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Directions to “ DAVID M WODICKA MD” Practice Location

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