Individual
CHARLES D WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2212 PENFIELD RD, SUITE 200, PENFIELD, NY 14526-1756
(585) 598-8569
(585) 388-7273
Mailing address
601 ELMWOOD AVE, BOX 278980, ROCHESTER, NY 14642-0001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
235630
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00847042
MEDICARE RAILROAD
NY
Enumeration date
06/30/2006
Last updated
07/05/2023
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