MEDICARE: ERIC J WOODARD 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	207T00000X	Neurological Surgery Physician	82094	MA

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	:	1932101433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC J WOODARD M.D.

Provider Business Mailing Address
First Line	:	PO BOX 86
Second Line	:
City	:	HINGHAM
State	:	MA
Zip	:	02043-0086
Country	:	US
Telephone Number	:	781-749-9017
Fax Number	:	781-749-2133

Provider Business Practice Location Address
First Line	:	125 PARKER HILL AVE
Second Line	:	CONVERSE 4
City	:	ROXBURY CROSSING
State	:	MA
Zip	:	02120-2847
Country	:	US
Telephone Number	:	617-754-6576
Fax Number	:	617-754-6420

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	03/30/2009

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