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Individual
DR. MARK S WOOD
Active
Individual
DR. MARK S WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
19048
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12450126
CAQH NUMBER
MS
01
—
873790
MS MEDICARE PROVIDER NUMBER
MS
Enumeration date
09/30/2006
Last updated
11/12/2019
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