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).
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 |
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 |
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 |
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 |
Street Address |
4610 KANAWHA AVE SW SUITE 302 |
City | CHARLESTON |
State | WV |
Zip Code | 25309-1320 |
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 |
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 Code | 207ND0101X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
Specialization | MOHS-Micrographic Surgery |
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/ |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912479056 | Beckley Dermatology Inc. | Dermatology | 300 Kenton Dr Ste 2, Charleston, WV 25311-1266 | 2018-12-31 |
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 |
City | CHARLESTON |
Zip Code | 25309 |
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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.