Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | MT194361 | PA |
NPI | 1194051417 |
---|---|
Provider Name | Andrew Cameron Wood |
First Address | Philadelphia, PA 19104-4399 |
Second Address | Philadelphia, PA 19104-4399 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2009 |
Last Update Date | 21/10/2009 |