Organization
MAW MEDICINE PC
Active
Other names
Michael A. Woods
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACKIE WOODS (PHYSICIAN BILLER)
(219) 689-6637
Entity
Organization
Contact information
Practice address
802 LAPORTE AVE, SUITE 102, VALPARAISO, IN 46383-5860
(219) 477-5242
Mailing address
709 PLAZA DR STE 2, SUITE 164, CHESTERTON, IN 46304-1573
(219) 689-6637
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
01048590A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225130867
PER SONANPI-MICHAEL WOODS
IN
05
—
200203200
—
IN
01
—
DE3546
RAILROAD MEDICARE
—
Enumeration date
12/26/2007
Last updated
08/15/2013
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