MEDICARE: DREW WOODWARD, MD, PC

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	207Q00000X	Family Medicine Physician	5447A	WY

General Provider Information

NPI Number	:	1275577017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DREW WOODWARD, MD, PC

Provider Business Mailing Address
First Line	:	304 S PARK ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-2836
Country	:	US
Telephone Number	:	307-237-5478
Fax Number	:	307-237-5575

Provider Business Practice Location Address
First Line	:	304 S PARK ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-2836
Country	:	US
Telephone Number	:	307-237-5478
Fax Number	:	307-237-5575

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DREW WOODWARD
Credential	:	M.D.
Telephone Number	:	307-237-5478

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	09/08/2008

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