Individual
SALLY WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2016-01013
NC
208000000X
Pediatrics Physician
Primary
2016-01013
NC
390200000X
Student in an Organized Health Care Education/Training Program
182715
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NCU906A
MEDICARE PTAN
NC
Enumeration date
05/08/2012
Last updated
08/21/2021
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