Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 12848 | SC |
NPI | 1013948892 |
---|---|
Provider Name | Robert Michael Wood |
First Address | Greenville, SC 29615-4545 |
Second Address | Greenville, SC 29605-5622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 05/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
128481 | (05) | SC |
4262977 | AETNA ID (01) | SC |
576007863130 | BLUECHOICE HEALTHPLAN ID (01) | SC |
576007863158 | BCBS OF SC ID (01) | SC |
9455844 | CIGNA ID (01) | SC |
D17592 | (02) | SC |
P002713367 | RR MEDICARE (01) | SC |