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Individual
WANDA LEE GODFREY
Active
Individual
WANDA LEE GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
93-00704
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36032
BCBS PIN
—
05
—
8936023
—
NC
01
—
93-00704
STATE LISCENCE #
NC
01
—
P00157587
MEDICARE RAILROAD
—
Enumeration date
10/02/2006
Last updated
07/21/2025
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