Provider Demographics
NPI:1073677803
Name:WOODWORTH, STEVEN HEATH (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:HEATH
Last Name:WOODWORTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 OSCEOLA ST
Mailing Address - Street 2:
Mailing Address - City:LAURIUM
Mailing Address - State:MI
Mailing Address - Zip Code:49913-2134
Mailing Address - Country:US
Mailing Address - Phone:906-337-6591
Mailing Address - Fax:906-337-6597
Practice Address - Street 1:205 OSCEOLA ST
Practice Address - Street 2:
Practice Address - City:LAURIUM
Practice Address - State:MI
Practice Address - Zip Code:49913-2134
Practice Address - Country:US
Practice Address - Phone:906-337-6591
Practice Address - Fax:906-337-6597
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301045420207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3462260Medicaid
MI010C17613OtherBLUE CROSS
MI0M28290016Medicare ID - Type Unspecified
MIE93756Medicare UPIN