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General NPI Number Information
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NPI Number | 1386769149
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Entity Type | Organization
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Legal Business Name | DOUGLAS B WOODRUFF MD PA
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 11/14/2014
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Provider Practice Location Address
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Address Line | 4419 FALLS RD SUITE E
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City | BALTIMORE
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State | MD
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Zip | 21211-1226
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Country | US
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Telephone | 410-889-5455
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Fax | 410-366-0651
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Provider Business Mailing Address
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Address Line | 4419 FALLS RD SUITE E
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City | BALTIMORE
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State | MD
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Zip | 21211-1226
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Country | US
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Telephone | 410-889-5455
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Fax | 410-366-0651
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Authorized Official
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Title or Position | AGENT FOR DOUGLAS B WOODRUFF MD PA
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Name | DR. DOUGLAS BRIAN WOODRUFF
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Credential | MD
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Telephone | 410-889-5455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D15413
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License Number State | MD
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