Individual
BEVERLY J WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
61 BARRA ROAD, BIDDEFORD, ME 04005
(207) 283-1441
(207) 523-1136
Mailing address
PO BOX 9746, PORTLAND, ME 04104-5040
(207) 791-3888
(207) 828-7850
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1080
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432490199
—
ME
Enumeration date
02/08/2006
Last updated
09/22/2020
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