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General NPI Number Information
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NPI Number | 1457329054
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Entity Type | Individual
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Provider Name | MICHAEL SCOTT WOODS MD
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Gender | Male
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 465 SAINT MICHAELS DR SUITE 110
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City | SANTA FE
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State | NM
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Zip | 87505-7670
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Country | US
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Telephone | 505-954-8720
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Fax |
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Provider Business Mailing Address
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Address Line | 455 SAINT MICHAELS DR MEDICAL STAFF OFFICE
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City | SANTA FE
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State | NM
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Zip | 87505-7601
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Country | US
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Telephone | 505-820-5227
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD2005-0673
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License Number State | NM
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