Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD011687E | PA |
NPI | 1366580458 |
---|---|
Provider Name | Dr. Albert Joseph Woodring |
First Address | Philadelphia, PA 19145 |
Second Address | Philadelphia, PA 19145-2301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 26/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0005939290003 | (05) | PA |