Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 67840 | GA |
N | 207VG0400X | Gynecologist | 67840 | GA |
N | 207VX0000X | Obstetrician | 67840 | GA |
NPI | 1124399423 |
---|---|
Provider Name | Dr. Demetrius Leon Woods II |
First Address | Marietta, GA 30066-6340 |
Second Address | Marietta, GA 30060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2012 |
Last Update Date | 30/10/2019 |