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NPI Code Detail

MEDICARE: SHAUN P WOOD MD

MEDICARE:   SHAUN P WOOD  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
12084P0800XPsychiatry Physician01044321AIN

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 : 1568461788
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAUN P WOOD MD
Provider Business Mailing Address
First Line : 10330 N MERIDIAN ST # 300
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46290-1024
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8401 HARCOURT RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-2036
Country : US
Telephone Number : 317-338-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 01/11/2017

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