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Deactivated NPI 1477737690 Deactivated / Inactive NPI Male Practitioner

Dr. David Jules Widom , DPM

Podiatrist • Plantation, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. David Widom has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 24, 2007
NPI Deactivation Date January 03, 2018
Total Practice Duration ~11 Years of Practice (2007 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. David Widom, DPM was a registered Podiatrist practicing in Plantation, FL. Throughout an active medical career spanning 11 years, Dr. Widom provided care at the practice location at 10361 NW 15TH ST until profile deactivation on 2018-01-03.

Practice Location & Contact Primary Location

Practice Address

10361 Nw 15th St

Plantation, FL 333226613

Telephone 9546491233
Fax 9544767949

Specialty Benchmarks & Practice Insights

Comparative analytics for Podiatrist in Plantation, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 29.0 Yrs
State Avg: 25.3 Yrs
Regional Practice Density
11 Specialists

Practicing in Plantation, FL (818 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Podiatrist Primary Specialty

NUCC Taxonomy Code: 213E00000X

State License FL PO1132

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 03, 2018

Record deactivated on January 03, 2018

NPI Profile Active December 24, 2007

NPI status registered as active in NPPES database

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Updated Practice Location December 24, 2007

Registered at 10361 NW 15TH ST, PLANTATION, FL 333226613 (Tel: 9546491233)

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Updated Business Mailing Address December 24, 2007

Registered at 10361 NW 15TH ST, PLANTATION, FL 333226613 (Tel: 9546491233)

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Provider Name / Credentials Updated December 24, 2007

Recorded as DAVID WIDOM, DPM

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 24, 2007

Podiatrist (License #PO1132 in FL)

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Initial NPI Registration & Enumeration December 24, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477737690
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 24, 2007
Last Update: December 24, 2007
Deactivation Date: January 03, 2018

Mailing Address

10361 Nw 15th St

Plantation, FL 333226613

Phone: 9546491233

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.