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Individual
EDWARD A WOODY
Active
Individual
EDWARD A WOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
11707
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040004355
RAILROAD MEDICARE
—
05
—
117073
—
SC
01
—
622337
SELECT HEALTH
SC
01
—
C14633
RAILRAOD MEDICARE GRP
—
01
—
PA1382
MEDICAID GROUP NUMBER
SC
Enumeration date
06/28/2006
Last updated
11/11/2020
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