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Individual

AMY R. WOOLDRIDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 MEMORIAL SQ STE 305, GREENFIELD, IN 46140-3308
(317) 462-6662
(317) 468-6275
Mailing address
PO BOX 129, GREENFIELD, IN 46140-0129
(317) 468-6270
(317) 468-6268

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01058321A
IN
207R00000X
Internal Medicine Physician
Primary
01058321A
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
01058321A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000364755
ANTHEM PIN#
IN
01
200311740H,L
MEDICAID GROUP#/LOCATION
05
200486100
IN
01
7482613
AETNA PIN#
IN
01
900284355
MEDICARE RAILROAD #
IN
Enumeration date
01/19/2006
Last updated
10/11/2010
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