Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 17286 | MS |
NPI | 1023064177 |
---|---|
Provider Name | Dr. Wayne Woo |
First Address | Flowood, MS 39232-9562 |
Second Address | Flowood, MS 39232-9562 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 10/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G73688 | (02) | MS |