Individual
STEPHEN R WOODWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 IVY BROOK RD, SUITE 205, SHELTON, CT 06484-6416
(203) 922-9466
(203) 922-9477
Mailing address
2 IVY BROOK RD, SUITE 205, SHELTON, CT 06484-6416
(203) 922-9466
(203) 922-9477
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
044476
CT
207UN0901X
Nuclear Cardiology Physician
044476
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001444760
—
CT
01
—
010044476CT01
ANTHEM
CT
Enumeration date
02/08/2006
Last updated
02/07/2013
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