Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 4301045420 | MI |
NPI | 1073677803 |
---|---|
Provider Name | Steven Heath Woodworth |
First Address | Laurium, MI 49913-2134 |
Second Address | Laurium, MI 49913-2134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 17/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010C17613 | BLUE CROSS (01) | MI |
3462260 | (05) | MI |
E93756 | (02) | MI |