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Individual
THOMAS D WOOLDRIDGE
Active
Individual
THOMAS D WOOLDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
6480
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00016236
—
MS
01
—
0010676
BLUE CROSS BLUE SHIELD
MS
05
—
008604410
—
AL
01
—
390001766
RAILROAD MEDICARE PIN
GA
01
—
6480
STATE LICENSED NUMBER
MS
01
—
73003901
BLUE CROSS PIN
—
Enumeration date
01/26/2006
Last updated
08/13/2010
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