Provider Demographics
NPI:1114020021
Name:WOYDICK, DANIEL PAUL (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:WOYDICK
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 1:400 CONLEY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:DEER LODGE
Mailing Address - State:MT
Mailing Address - Zip Code:59722-8708
Mailing Address - Country:US
Mailing Address - Phone:406-415-6522
Mailing Address - Fax:
Practice Address - Street 1:400 CONLEY LAKE RD
Practice Address - Street 2:
Practice Address - City:DEER LODGE
Practice Address - State:MT
Practice Address - Zip Code:59722-8708
Practice Address - Country:US
Practice Address - Phone:406-415-6522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT49078207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine