Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 034281 | GA |
NPI | 1083634067 |
---|---|
Provider Name | William Wood |
First Address | Atlanta, GA 30322-1013 |
Second Address | Atlanta, GA 30322-1013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
022854 | BCBS (01) | GA |
1170276 | UNITED HEALTHCARE (01) | GA |
515113 | US HEALTHCARE (01) | GA |
B74390001 | (02) | GA |
Y 19910801 | PHCS (01) | GA |