1891085809 NPI number — DR. NEIL MCIVER WOODY M.D.

Table of content: DR. NEIL MCIVER WOODY M.D. (NPI 1891085809)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891085809 NPI number — DR. NEIL MCIVER WOODY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WOODY
Provider First Name:
NEIL
Provider Middle Name:
MCIVER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1891085809
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3702 SILSBY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNIVERSITY HEIGHTS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44118-3648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-410-4372
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9500 EUCLID AVE
Provider Second Line Business Practice Location Address:
T28 RADIATION ONCOLOGY
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44195-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-445-6940
Provider Business Practice Location Address Fax Number:
216-445-1068
Provider Enumeration Date:
04/11/2011

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: 2085R0001X , with the licence number:  35.128545 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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