Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | ME19338 | FL |
NPI | 1033198106 |
---|---|
Provider Name | Craig D. Woodard |
First Address | Sunrise, FL 33345-2375 |
Second Address | North Miami Beach, FL 33169-5513 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 09/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
92527 | BCBS OF FL (01) | FL |
D60096 | (02) |