Wodecki, Tadeusz K
Wodecki, Tadeusz K is an sole proprietor health care provider with primary practice located at 2256 Rockbridge Rd , Stone Mountain GA 30087. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Wodecki, Tadeusz K can be contacted via phone (770) 413-1300.Contact Information
Primary practice address
2256 Rockbridge Rd
Stone Mountain GA 30087
Phone: (770) 413-1300
Fax: (770) 413-0547
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 029264 | Georgia |
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 207RA0000X | 200301312 | North Carolina |
Profile Details
| NPI number | 1619994472 |
|---|---|
| LBN Legal business name | Wodecki, Tadeusz K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Jan 17th, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619994472 | NPPES |
| Georgia | Other | 1619994472 | NPI |
| Georgia | MEDICAID | 00543397A | NPI |
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