Healthcare Provider Details

I. General information

NPI: 1215900543
Provider Name (Legal Business Name): DONALD M WOODFORD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 11/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 CENTRAL ST
WEYMOUTH MA
02190-2309
US

IV. Provider business mailing address

16 CENTRAL ST
WEYMOUTH MA
02190-2309
US

V. Phone/Fax

Practice location:
  • Phone: 781-331-6570
  • Fax: 781-340-3782
Mailing address:
  • Phone: 781-331-6570
  • Fax: 781-340-3782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number39547
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: