Individual
MATTHEW J. WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1512 12TH AVE RD, NAMPA, ID 83686-6008
(208) 463-5029
Mailing address
1512 12TH AVE RD, NAMPA, ID 83686-6008
(208) 463-5029
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
M-6494
ID
2086S0129X
Vascular Surgery Physician
328720-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3992300
—
ID
Enumeration date
11/09/2006
Last updated
04/17/2008
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