MEDICARE: STEVEN GERARD WOODWARD JR. 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
1	208600000X	Surgery Physician	D0097042	MD

General Provider Information

NPI Number	:	1689037863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN GERARD WOODWARD JR. M.D.

Provider Business Mailing Address
First Line	:	1015 WALNUT ST RM 620
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5005
Country	:	US
Telephone Number	:	215-955-6864
Fax Number	:	215-955-2878

Provider Business Practice Location Address
First Line	:	1015 WALNUT ST RM 620
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5005
Country	:	US
Telephone Number	:	215-955-6864
Fax Number	:	215-955-2878

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

Provider Enumeration Date	:	04/04/2016
Last Update Date	:	12/30/2024

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