Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MD041989E | PA |
NPI | 1033165287 |
---|---|
Provider Name | Dr. Craig Wood |
First Address | Radnor, PA 19087-2802 |
Second Address | Radnor, PA 19087-2802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 03/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001182730 | (05) | PA |
E70720 | (02) | PA |