1609364041 NPI number — DR. KATHERINE MARIE SENF WOOD MD

Table of content: DR. KATHERINE MARIE SENF WOOD MD (NPI 1609364041)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609364041 NPI number — DR. KATHERINE MARIE SENF WOOD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WOOD
Provider First Name:
KATHERINE
Provider Middle Name:
MARIE SENF
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SENF
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1609364041
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9565 HIGHWAY 78 BLDG 600A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LADSON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29456-4116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-202-0288
Provider Business Mailing Address Fax Number:
843-202-0284

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9565 HIGHWAY 78 BLDG 600A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LADSON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29456-4116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-202-0288
Provider Business Practice Location Address Fax Number:
843-202-0284
Provider Enumeration Date:
05/01/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: MD52771 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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