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General NPI Number Information
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NPI Number | 1730384306
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Entity Type | Individual
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Provider Name | MEREDITH ANN WOOD P.A.
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Gender | Female
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 02/20/2014
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Provider Practice Location Address
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Address Line | 1135 W UNIVERSITY DR SUITE 450
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-1871
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Country | US
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Telephone | 248-650-2400
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Fax | 248-650-4596
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Provider Business Mailing Address
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Address Line | 4567 BURNLEY DR
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48304-3718
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Country | US
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Telephone | 248-650-2400
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Fax | 248-650-4596
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 5601003156
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License Number State | MI
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