DR. DAVID JUDY


Address: 4610 Kanawha Ave Sw, Suite 302, Charleston, WV 25309-1320
Phone: 3049257546

DR. DAVID JUDY (NPI# 1619144433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619144433
Entity Type Individual
Full Name DR. DAVID JUDY
Credential D.O.
Practice Address 4610 Kanawha Ave Sw
Suite 302
Charleston
WV 25309-1320
Mailing Address # L-3555
Columbus
OH 43260-0001
Practice Telephone 3049257546
Practice Fax Number 6812058369
Mailing Telephone 3049257546
Mailing Fax Number 6812058369
Enumeration Date 2008-05-12
Last Update Date 2014-10-20
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207N00000X Dermatology 2596 WV Allopathic & Osteopathic Physicians
N 207N00000X Dermatology OS 11120 FL Allopathic & Osteopathic Physicians
N 207N00000X Dermatology 2007-00740 NC Allopathic & Osteopathic Physicians
Y 207ND0101X Dermatology
Specialization: MOHS-Micrographic Surgery
2596 WV Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WV 3810023193 05
WV CIGNA 5679351 01
WV HEALTHNET/TRICARE 1619144433 01
WV HEALTHSMART PEIA 1619144433 01
WV UMWA HEALTH PLAN OF WV 1619144433 01
WV UNITED HEALTHCARE 1619144433 01
WV HIGHMARK BCBS 2707397 01

Other Providers DAVID JUDY

NPI Name Taxonomy Address Enumeration
1548534431 David Judy Pharmacist 2512 Tobacco Rd, Hephzibah, GA 30815-7099 2012-02-24
1689652976 David Lewis Judy Dentist 8849 Shelby St, Ste A, Indianapolis, IN 46227-7508 2006-01-06
1679761399 David Judy Counselor 504 Micah Drive, Drawer M, Olney, IL 62450-0913 2007-10-09

Office Location

Street Address 4610 KANAWHA AVE SW
SUITE 302
City CHARLESTON
State WV
Zip Code 25309-1320

Providers in the same location

NPI Name Taxonomy Address Enumeration
1841762341 Kristyn E. Gore Nurse Practitioner 4610 Kanawha Ave Sw, Charleston, WV 25309-1367 2018-12-20
1710318530 Malea Joy Smith Nurse Practitioner 4610 Kanawha Ave Sw, Sw # 301, Charleston, WV 25309-1367 2013-12-04

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699376905 Lovie Bradshaw Technician 4823 Tennessee St., South Charleston, WV 25309 2020-11-03
1306447735 Barbara Mackenzie Technician 4224 Kanawha Turnpike, South Charleston, WV 25309 2020-11-03
1548861974 Sarah Nichols Technician 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 2020-11-03
1629690177 Jennifer Mabry-goins Technician 4505 River Avenue, S Charleston, WV 25309 2020-05-07
1811537715 Brandon C Dean Psychologist 4857 Macorkle Ave. Sw, South Charleston, WV 25309 2020-01-09
1467096057 Linda Mullins Technician 60 Hayvon Lane, South Charleston, WV 25309 2019-11-06
1831743616 Ann Myriah Beck Nurse Practitioner 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 2019-07-30
1942671227 Edward W Eskew Family Medicine 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 2015-10-13
1720468218 Link Investments LLC Pharmacy 5151 Macorkle Avenue, South Charleston, WV 25309 2015-06-01
1366840951 Eyemart Express LLC Eyewear Supplier (Equipment, not the service) 304 Southbridge Blvd., S.ccharleston, WV 25309 2014-12-12
Find all providers in zip 25309

Taxonomy Information

Taxonomy Code 207ND0101X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology
Specialization MOHS-Micrographic Surgery

Taxonomy Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912479056 Beckley Dermatology Inc. Dermatology 300 Kenton Dr Ste 2, Charleston, WV 25311-1266 2018-12-31

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1275005316 Beckley Dermatology Inc. Dermatology 1000 Tavern Rd Ste 400, Martinsburg, WV 25401-2853 2018-12-31
1740752880 Beckley Dermatology Inc. Dermatology 300 Prosperity Ln Ste 207, Logan, WV 25601-3743 2018-12-31
1588059646 Vlad Codrea Dermatology Mary Babb Randolph Cancer Center, 1 Medical Center Dr., Morgantown, WV 26506 2015-04-04
1568076180 Beckley Dermatology Inc. Dermatology 150 E 2nd Ave, Williamson, WV 25661-3602 2020-09-01
1578035606 Beckley Dermatology Inc. Dermatology 508 New Hope Rd Ste 102, Princeton, WV 24740-2265 2018-12-31
1578717997 Adeel Ahmad Dermatology 94 Brookshire Ln, Beckley, WV 25801-6765 2008-11-12
1033246814 Gary A Ganzer Dermatology 58 16th St, Wheeling, WV 26003-3660 2007-02-27

Competitor

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City CHARLESTON
Zip Code 25309

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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