Doctor Name: | DIANE D WOOD |
NPI Number: | 1083688337 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | MA000661L |
Business Practice Address: | 4200 Hospital Rd Coal Township, PA - 178669668 |
Business Phone Number: | 5706442042 |
Business Fax Number: | 5706444582 |
Mailing Address: | 4200 Hospital Rd, COAL TOWNSHIP |
State: | PA |
Postal Code: | 178669668 |
Phone Number: | 5706442042 |
Fax Number: | 5706444582 |
NPI Enumeration Date: | 02/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MA000661L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |