Provider Demographics
NPI:1871972836
Name:WOODRUM, CHELSEY
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:WOODRUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 TREYBROOKE CIR
Mailing Address - Street 2:APT 24
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5961
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:306 TREYBROOKE CIR
Practice Address - Street 2:APT 24
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5961
Practice Address - Country:US
Practice Address - Phone:617-755-7982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology