Provider Demographics
NPI:1326047770
Name:LUDWICK, DAVID JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:LUDWICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 5TH AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4213
Mailing Address - Country:US
Mailing Address - Phone:717-262-9700
Mailing Address - Fax:717-264-6522
Practice Address - Street 1:825 5TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4213
Practice Address - Country:US
Practice Address - Phone:717-262-9700
Practice Address - Fax:717-264-6522
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037338E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0070443930002Medicaid
PA180032028OtherRAILROAD MEDICARE
PACG7940OtherRAILROAD MEDICARE
PA0015389300009Medicaid
MD404603000Medicaid
PAE73399Medicare UPIN
MD523M810FMedicare PIN
MD404603000Medicaid
PA0015389300009Medicaid
PA1303520001Medicare NSC