1871057679 NPI number — DR. WENDY MAXINE WOODS MD

Table of content: DR. WENDY MAXINE WOODS MD (NPI 1871057679)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871057679 NPI number — DR. WENDY MAXINE WOODS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WOODS
Provider First Name:
WENDY
Provider Middle Name:
MAXINE
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:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871057679
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/25/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
THE ARCHES
Provider Second Line Business Mailing Address:
13 BERRY HILL RD
Provider Business Mailing Address City Name:
PAGET
Provider Business Mailing Address State Name:
PAGET
Provider Business Mailing Address Postal Code:
DV 03
Provider Business Mailing Address Country Code:
BM
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
THE ARCHES
Provider Second Line Business Practice Location Address:
13 BERRY HILL RD
Provider Business Practice Location Address City Name:
PAGET
Provider Business Practice Location Address State Name:
PAGET
Provider Business Practice Location Address Postal Code:
DV 03
Provider Business Practice Location Address Country Code:
BM
Provider Business Practice Location Address Telephone Number:
441-236-0522
Provider Business Practice Location Address Fax Number:
441-236-9066
Provider Enumeration Date:
01/25/2019

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: 207V00000X , with the licence number:  MD063749L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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