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Individual

DEBORAH WOODBURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
612 FAYETTE ST, 2ND FLOOR, CONSHOHOCKEN, PA 19428-1797
(610) 828-8500
(610) 828-9736
Mailing address
612 FAYETTE ST, 2ND FLOOR, CONSHOHOCKEN, PA 19428-1797
(610) 828-8500
(610) 828-9736

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD056674L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015954810004
PA
01
0128798000
IBC - PC/KHPE
PA
01
0159548101
AMERICHOICE (UHC MA PLAN)
PA
01
0585148
AETNA HMO
PA
01
080085941
RRM
PA
01
1076963
KEYSTONE MERCY
PA
01
10939019
CAQH ID#
PA
01
17213-MD056674L
HEALTH PARTNERS
PA
01
223718
ALLIANCE/OPT CHC (MAMSI)
PA
01
5506461
AETNA PPO
PA
01
5852947
CIGNA HMO/PPO
PA
01
891990
HIGHMARK BLUE SHIELD
PA
01
967674
PHCS
PA
01
P1293177
OXFORD
PA
Enumeration date
06/05/2006
Last updated
07/09/2007
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