MEDICARE: DR. KRISTI E WOODS 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	208000000X	Pediatrics Physician	200100109	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689634610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTI E WOODS M.D.

Provider Business Mailing Address
First Line	:	1655 WAKE DR
Second Line	:	SUITE 101
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-4745
Country	:	US
Telephone Number	:	919-556-4779
Fax Number	:	919-556-5277

Provider Business Practice Location Address
First Line	:	4019 VILLAGE PARK DR
Second Line	:
City	:	KNIGHTDALE
State	:	NC
Zip	:	27545-7044
Country	:	US
Telephone Number	:	919-266-5059
Fax Number	:	919-266-4309

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	07/19/2013

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