Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 12825 | AZ |
N | 207P00000X | Emergency Physician | MD021106E | PA |
Y | 207Q00000X | Family Doctor | 12825 | AZ |
N | 207Q00000X | Family Doctor | MD021106E | PA |
NPI | 1013192442 |
---|---|
Provider Name | Dr. Ramona Beatrice Woodriffe |
First Address | Mesa, AZ 85206 |
Second Address | Mesa, AZ 85206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2008 |
Last Update Date | 21/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
283177 | ARIZONA AHCCCS ID (01) | AZ |
D88982 | (02) | AZ |