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NPI Code Detail

MEDICARE: MS. BEVERLY J. WOOD

MEDICARE: MS. BEVERLY J. WOOD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801068382MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1N44500011OTHERMIMEDICARE ID

General Provider Information

NPI Number : 1144383829
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BEVERLY J. WOOD
Provider Business Mailing Address
First Line : 500 BARFIELD DR
Second Line :
City : HASTINGS
State : MI
Zip : 49058-9018
Country : US
Telephone Number : 269-948-8041
Fax Number : 269-948-3916
Provider Business Practice Location Address
First Line : 500 BARFIELD DR
Second Line :
City : HASTINGS
State : MI
Zip : 49058-9018
Country : US
Telephone Number : 269-948-8041
Fax Number : 269-948-3916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 03/09/2017

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