Provider Demographics
NPI:1447229133
Name:SEDWICK, RICHARD EN (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:EN
Last Name:SEDWICK
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 1:1885 PORT REPUBLIC RD
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3533
Mailing Address - Country:US
Mailing Address - Phone:540-433-6613
Mailing Address - Fax:540-433-6605
Practice Address - Street 1:1885 PORT REPUBLIC RD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3533
Practice Address - Country:US
Practice Address - Phone:540-433-6613
Practice Address - Fax:540-433-6605
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101029047174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB09625Medicare UPIN