Individual
CHARLES C WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2636 LOUDOUN ST, VIRGINIA BEACH, VA 23456-2438
(757) 301-9978
(757) 301-9978
Mailing address
2636 LOUDOUN ST, VIRGINIA BEACH, VA 23456-2438
(757) 301-9978
(757) 301-9978
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001510
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
278240
ANTHEM
VA
01
—
P00013235
RAILROAD MEDICARE
—
Enumeration date
07/19/2006
Last updated
03/07/2023
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