Healthcare Provider Details

I. General information

NPI: 1629053111
Provider Name (Legal Business Name): ROBERT M WOOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 11/23/2025
Certification Date: 12/10/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16240 BENNETT RD
CULPEPER VA
22701-4630
US

IV. Provider business mailing address

MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

V. Phone/Fax

Practice location:
  • Phone: 540-825-5951
  • Fax: 540-825-5971
Mailing address:
  • Phone: 336-716-2255
  • Fax: 336-716-3202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number39501
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG74883
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101043218
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: