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Individual
MICHAEL WOODS
Active
Individual
MICHAEL WOODS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036073539
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
833230
MEDICARE GROUP FOR PONTIAC
—
01
—
IL2613
MEDICARE GROUP PTAN
IL
Enumeration date
09/14/2006
Last updated
10/06/2020
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