Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 17301 | NE |
N | 207V00000X | Obstetrician & Gynecologist | 27220 | IA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 27220 | IA |
NPI | 1487654695 |
---|---|
Provider Name | Dr. Michael P Woods |
First Address | Shenandoah, IA 51601-2355 |
Second Address | Shenandoah, IA 51601-2355 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 25/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
160035546 | MEDICARE RR (01) | |
2059832 | (05) | IA |
91178487513 | (05) | NE |
E20288 | (02) |