Provider Demographics
NPI:1912104209
Name:WOJCIKEWYCH, DEVON S (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVON
Middle Name:S
Last Name:WOJCIKEWYCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEVON
Other - Middle Name:SUMMERS
Other - Last Name:FLETCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1934
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:WOMEN'S HEALTH/ INTERNAL MEDICNE
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-327-8806
Practice Address - Fax:804-327-3065
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249910207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1912104209Medicaid
VA1912104209Medicaid