Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 72130 | MA |
NPI | 1053300467 |
---|---|
Provider Name | David Alden Wood |
First Address | Hyannis, MA 02601-3009 |
Second Address | Hyannis, MA 02601-3009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2005 |
Last Update Date | 09/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3107701 | (05) | MA |
F53829 | (02) | MA |