Provider Demographics
NPI:1225130867
Name:WOODS, MICHAEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:WOODS
Suffix:
Gender:M
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:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46624-0194
Mailing Address - Country:US
Mailing Address - Phone:219-477-5242
Mailing Address - Fax:219-477-4859
Practice Address - Street 1:2000 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2800
Practice Address - Country:US
Practice Address - Phone:219-477-5242
Practice Address - Fax:219-477-4859
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048590A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200203200Medicaid
IN01048590BOtherCSR
P00287448OtherRAILROAD MEDICARE
IN01048590AOtherIN LICENSE
IN01048590AOtherIN LICENSE
IN232970AMedicare PIN
IN01048590AOtherIN LICENSE