Individual
EDWARD A WOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
146 E HOSPITAL DR STE 200, WEST COLUMBIA, SC 29169
(803) 936-7530
(803) 936-7535
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
11707
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040004355
RAILROAD MEDICARE
—
05
—
117073
—
SC
01
—
622337
SELECT HEALTH
SC
01
—
C14633
RAILRAOD MEDICARE GRP
—
01
—
PA1382
MEDICAID GROUP NUMBER
SC
Enumeration date
06/28/2006
Last updated
11/11/2020
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