Individual
DAVID L TEDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 MEDICAL DR, TALLAHASSEE, FL 32308-4646
(850) 216-0100
(850) 201-4834
Mailing address
1300 MEDICAL DR, TALLAHASSEE, FL 32308-4646
(850) 216-0100
(850) 201-4834
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
015832
GA
207RC0000X
Cardiovascular Disease Physician
Primary
ME29338
FL
207RI0011X
Interventional Cardiology Physician
ME29338
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
UNITED HEALTH CARE
FL
01
—
00000
VISTA
GA
05
—
000164898A
—
GA
05
—
009979030
—
AL
05
—
058454100
—
FL
01
—
37230
BCBS
FL
Enumeration date
08/25/2005
Last updated
07/27/2016
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