Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 16057 | SC |
N | 2084N0400X | Neurologist | MD37595 | TN |
NPI | 1023009651 |
---|---|
Provider Name | Craig S Woodard |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29424-8908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 22/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F26902 | (02) | TN |