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General NPI Number Information
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NPI Number | 1235382771
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Entity Type | Organization
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Legal Business Name | DAVID J WOOD MD FRCPC,PC
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 6551 LOISDALE CT SUITE 155
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City | SPRINGFIELD
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State | VA
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Zip | 22150-1828
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Country | US
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Telephone | 703-921-0692
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Fax |
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Provider Business Mailing Address
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Address Line | 6551 LOISDALE CT SUITE 155
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City | SPRINGFIELD
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State | VA
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Zip | 22150-1828
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Country | US
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Telephone | 703-921-0692
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID JOHN WOOD
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Credential | MD
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Telephone | 703-921-0692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 0101038559
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License Number State | VA
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