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NPI Code Detail

MEDICARE: DR. CEDRIC WOOD

MEDICARE: DR. CEDRIC WOOD
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
1183500000XPharmacist12535SC

General Provider Information

NPI Number : 1679870711
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CEDRIC WOOD
Provider Business Mailing Address
First Line : 3701 N KINGS HWY
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-2977
Country : US
Telephone Number : 843-448-9104
Fax Number : 843-448-9180
Provider Business Practice Location Address
First Line : 3701 N KINGS HWY
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-2977
Country : US
Telephone Number : 843-448-9104
Fax Number : 843-448-9180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2011
Last Update Date : 02/25/2011

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Directions to “ DR. CEDRIC WOOD ” Practice Location

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