Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 01388 | MD |
NPI | 1174532311 |
---|---|
Provider Name | Wendy Woods |
First Address | Bowie, MD 20716-1303 |
Second Address | Laurel, MD 20708-3143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 08/07/2007 |