Provider Demographics
NPI:1558332809
Name:MCCURDY, WENDY EDITH (MD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:EDITH
Last Name:MCCURDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 N WILMOT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-2701
Mailing Address - Country:US
Mailing Address - Phone:520-795-2889
Mailing Address - Fax:520-795-6321
Practice Address - Street 1:677 N WILMOT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2701
Practice Address - Country:US
Practice Address - Phone:520-795-2889
Practice Address - Fax:520-795-6321
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ241392085R0202X, 2085B0100X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ005472OtherGROUP MEDICAID ID
AZ300129920OtherMEDICARE RAILROAD
WAG8934159OtherGROUP PTAN FOR PHYSICIAN READING TELERADIOLOGY FROM WA
WAG8934376OtherINDIVIDUAL PTAN FOR PHYSICIAN READING TELERADIOLOGY FROM WA
AZ645385Medicaid
AZCS7943OtherGROUP MEDICARE RAILROAD ID & PTAN
AZZWCBBMOtherGROUP MEDICARE ID
AZ1558332809OtherPHYSICIAN INDIVIDUAL NPI
AZ1841261989OtherGROUP NPI
F85853Medicare UPIN
AZZ68838Medicare PIN