Provider Demographics
NPI:1073544300
Name:WOODROW, VIRGINIA (MD)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:WOODROW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 DITMER RD
Mailing Address - Street 2:
Mailing Address - City:LAURA
Mailing Address - State:OH
Mailing Address - Zip Code:45337-8742
Mailing Address - Country:US
Mailing Address - Phone:937-947-1514
Mailing Address - Fax:
Practice Address - Street 1:500 E COURT ST
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-2810
Practice Address - Country:US
Practice Address - Phone:937-492-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35047163-W2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0943948Medicaid
OH000000374988OtherANTHEM BLUE CROSS
OH000000374988OtherANTHEM BLUE CROSS