Individual
JOHN ROBERT WOODS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-7459
(574) 647-3411
Mailing address
328 N MICHIGAN ST, SUITE 200, SOUTH BEND, IN 46601-1244
(574) 647-1842
(574) 647-1825
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01031817A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000636043
ANTHEM PROVIDER NUMBER
IN
05
—
100385150
—
IN
Enumeration date
09/22/2006
Last updated
02/15/2010
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