Provider Demographics
NPI:1447204557
Name:WOODWARD, PATRICK MALCOM (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:MALCOM
Last Name:WOODWARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 28780
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-8780
Mailing Address - Country:US
Mailing Address - Phone:804-346-1515
Mailing Address - Fax:804-270-2888
Practice Address - Street 1:6900 FOREST AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1729
Practice Address - Country:US
Practice Address - Phone:804-346-1515
Practice Address - Fax:804-270-2888
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2012-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058133207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA104376OtherANTHEM BCBS
VA2570434OtherAETNA HMO
VA5611130Medicaid
VA10002407OtherOPTIMA
VA1103346OtherCIGNA
VA416370OtherSOUTHERN HEALTH
VA7389217OtherAETNA NON-HMO
VA0103017OtherUNITED HEALTHCARE
VA0103017OtherUNITED HEALTHCARE
VACB4715Medicare Oscar/Certification
VA416370OtherSOUTHERN HEALTH
VA5611130Medicaid
VA003246V74Medicare PIN