Tedrick, David L

Tedrick, David L is an individual health care provider with primary practice located at 1300 Medical Dr , Tallahassee FL 32308-4646. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Tedrick, David L can be contacted via phone (850) 216-0100.

Contact Information

Primary practice address
1300 Medical Dr Tallahassee FL 32308-4646
Phone: (850) 216-0100
Fax: (850) 201-4834
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X ME29338 Florida
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 015832 Georgia
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X ME29338 Florida

Profile Details

NPI number 1407849342
LBN Legal business name Tedrick, David L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2005
Last updated Jul 27th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407849342 NPPES
Alabama MEDICAID 009979030
Alabama Other 00000
Alabama Other 37230
Alabama Other 00000
Alabama Other 00000
Alabama Other 00000
Alabama Other 00000
Alabama Other 00000
Alabama MEDICAID 058454100
Alabama Other 00000
Alabama MEDICAID 000164898A

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