Provider Demographics
NPI:1821022666
Name:LUDOVICO, WILLIAM (MS PT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:LUDOVICO
Suffix:
Gender:M
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:305 N UNION ST STE 101
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3453
Practice Address - Country:US
Practice Address - Phone:302-778-0810
Practice Address - Fax:302-778-0812
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25934225100000X
PAPT005800L225100000X
DEJ1-0002514225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
093092Medicare ID - Type Unspecified