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NPI Code Detail

MEDICARE: DR. KENNETH ROGER WOO M.D.

MEDICARE: DR. KENNETH ROGER WOO M.D.
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
1208800000XUrology PhysicianD0058566MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003887019
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH ROGER WOO M.D.
Provider Business Mailing Address
First Line : 2007 ROCK SPRING RD
Second Line :
City : FOREST HILL
State : MD
Zip : 21050-2620
Country : US
Telephone Number : 410-879-4879
Fax Number :
Provider Business Practice Location Address
First Line : 2007 ROCK SPRING RD
Second Line :
City : FOREST HILL
State : MD
Zip : 21050-2620
Country : US
Telephone Number : 410-879-4879
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2006
Last Update Date : 08/05/2014

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