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Individual

LISA D WOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1540 SPRING VALLEY DR, HUNTINGTON, WV 25704-9501
(304) 429-6741
(304) 426-0262
Mailing address
1540 SPRING VALLEY DR, HUNTINGTON, WV 25704-9300
(304) 429-6741

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19616
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0013508000
WV
01
001721957
BLUE CROSS BLUE SHIELD
WV
01
1045595
DWC
WV
01
7545258
AETNA
WV
Enumeration date
08/18/2006
Last updated
06/29/2021
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