Healthcare Provider Details

I. General information

NPI: 1720400526
Provider Name (Legal Business Name): SAMUEL WOODS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2014
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1149 LINCOLN WAY E
MASSILLON OH
44646-6950
US

IV. Provider business mailing address

1149 LINCOLN WAY E
MASSILLON OH
44646-6950
US

V. Phone/Fax

Practice location:
  • Phone: 330-830-7900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.145331
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: