Individual
DR. RICHARD MARTIN CHUDACOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1155 EAST MTN BLVD, WILKES BARRE, PA 18702-7906
(570) 808-7916
(570) 808-6006
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 808-7916
(570) 808-6006
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD479668
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11340275064
—
TX
05
—
115868400
—
FL
Enumeration date
09/13/2005
Last updated
11/20/2025
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