Provider Demographics
NPI:1811058860
Name:WOJDA, ROBERT Z (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:Z
Last Name:WOJDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 950244
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0244
Mailing Address - Country:US
Mailing Address - Phone:812-218-8926
Mailing Address - Fax:812-218-8930
Practice Address - Street 1:712 E MUHAMMAD ALI BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1643
Practice Address - Country:US
Practice Address - Phone:502-568-6972
Practice Address - Fax:502-996-8309
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26077207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64260771Medicaid
000000049528OtherBLUE CROSS FACET ID
KY0236409Medicare ID - Type Unspecified