Provider Demographics
NPI:1205822798
Name:WOOD, MICHAEL JOSEPH (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:WOOD
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Gender:M
Credentials:MD MPH
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Mailing Address - Street 1:755 SCOTT CIR STE B220
Mailing Address - Street 2:15TH AEROSPACE MEDICINE SQUADRON
Mailing Address - City:JB PHH
Mailing Address - State:HI
Mailing Address - Zip Code:96853-5399
Mailing Address - Country:US
Mailing Address - Phone:808-448-6177
Mailing Address - Fax:808-448-6755
Practice Address - Street 1:755 SCOTT CIR STE B220
Practice Address - Street 2:15TH AEROSPACE MEDICINE SQUADRON
Practice Address - City:JB PHH
Practice Address - State:HI
Practice Address - Zip Code:96853-5399
Practice Address - Country:US
Practice Address - Phone:808-448-6177
Practice Address - Fax:808-448-6755
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2012-11-06
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Provider Licenses
StateLicense IDTaxonomies
TXK36592083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN