MEDICARE: DR. PAULA J WOODWARD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	92-186903-1205	UT

General Provider Information

NPI Number	:	1003808429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAULA J WOODWARD MD

Provider Business Mailing Address
First Line	:	UNIVERSTIY OF UTAH DEPARTMENT OF RADIOLOGY
Second Line	:	50 NORTH MEDICAL DRIVE, #1A71
City	:	SALT LAKE CTY
State	:	UT
Zip	:	84132-2410
Country	:	US
Telephone Number	:	801-581-7553
Fax Number	:	801-581-2414

Provider Business Practice Location Address
First Line	:	UNIVERSTIY OF UTAH DEPARTMENT OF RADIOLOGY
Second Line	:	50 NORTH MEDICAL DRIVE, #1A71
City	:	SALT LAKE CTY
State	:	UT
Zip	:	84132-2410
Country	:	US
Telephone Number	:	801-581-7553
Fax Number	:	801-581-2414

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	12/20/2021

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