Provider Demographics
NPI:1164407755
Name:WOOD, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3739 HIXSON PIKE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-1108
Mailing Address - Country:US
Mailing Address - Phone:423-875-0999
Mailing Address - Fax:423-875-0896
Practice Address - Street 1:3739 HIXSON PIKE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415
Practice Address - Country:US
Practice Address - Phone:423-875-0999
Practice Address - Fax:423-875-0896
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2014-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN37690207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3884045Medicare ID - Type Unspecified