Individual
TIMOTHY GERRARD WOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
22243
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC3336
RAILROAD MEDICARE
SC
01
—
P00162061
RAILROAD MEDICARE PIN
SC
Enumeration date
12/13/2005
Last updated
02/19/2008
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