MEDICARE: MICHELLE WOO OD

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	152W00000X	Optometrist	0618002580	VA
2	152W00000X	Optometrist	2504	NC

General Provider Information

NPI Number	:	1295264380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE WOO OD

Provider Business Mailing Address
First Line	:	603 3RD AVE NE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-5136
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2266 US HIGHWAY 70 SE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-5164
Country	:	US
Telephone Number	:	828-979-3010
Fax Number	:

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

Provider Enumeration Date	:	06/12/2017
Last Update Date	:	12/13/2021

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Directions to “ MICHELLE WOO OD” Practice Location

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