Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | D0058566 | MD |
NPI | 1003887019 |
---|---|
Provider Name | Dr. Kenneth Roger Woo |
First Address | Forest Hill, MD 21050-2620 |
Second Address | Forest Hill, MD 21050-2620 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2006 |
Last Update Date | 05/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
986561602 | (05) | MD |
H65687 | (02) | MD |