Provider Demographics
NPI:1962793075
Name:CODY, CANDICE LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:LEIGH
Last Name:CODY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:CANDICE
Other - Middle Name:LEIGH
Other - Last Name:WOODCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8008 WESTPARK DR
Mailing Address - Street 2:MID-ATLANTIC KAISER PERMANENTE, TYSON'S CORNER ASC
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3109
Mailing Address - Country:US
Mailing Address - Phone:703-287-6436
Mailing Address - Fax:
Practice Address - Street 1:8008 WESTPARK DR
Practice Address - Street 2:MID-ATLANTIC KAISER PERMANENTE, TYSON'S CORNER ASC
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3109
Practice Address - Country:US
Practice Address - Phone:703-287-6436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-23
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101258230207L00000X
MDD79900207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology