Individual
DR. MATTHEW LEO WOODHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
404 JEFFERSON ST, PELLA, IA 50219-1257
(641) 628-3150
(641) 628-8901
Mailing address
404 JEFFERSON ST, PELLA, IA 50219-1257
(641) 628-3150
(641) 628-8901
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4473
IA
207R00000X
Internal Medicine Physician
Primary
DO-04473
IA
207R00000X
Internal Medicine Physician
OS11367
FL
208M00000X
Hospitalist Physician
DO-04473
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760621791
NPI NUMBER
—
01
—
DO04473
IOWA LICENSE
IA
Enumeration date
02/15/2009
Last updated
09/26/2024
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