NPI Lookup
NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

DAVID JUDY, DO
4610 KANAWHA AVE SW
SUITE 302
CHARLESTON, WV25309-1320
 Phone: 304-925-7546
 Fax: 681-205-8369
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
 

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for DAVID JUDY · (Male)

NPI Number 1619144433
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/12/2008
Last updated 10/20/2014 - More than a year ago
Sole proprietor 1 Yes
Identifiers
FL License # OS 11120
NC License # 2007-00740
WV License # 2596
WV Medicaid 3810023193
WV Other 5679351 CIGNA
WV Other 1619144433 HEALTHNET/TRICARE
WV Other 1619144433 HEALTHSMART PEIA
WV Other 2707397 HIGHMARK BCBS
WV Other 1619144433 UMWA HEALTH PLAN OF WV
WV Other 1619144433 UNITED HEALTHCARE
Hospital affiliation(s) n/a
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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