Provider Demographics
NPI:1235382771
Name:DAVID J WOOD MD FRCPC,PC
Entity Type:Organization
Organization Name:DAVID J WOOD MD FRCPC,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-921-0692
Mailing Address - Street 1:6551 LOISDALE CT
Mailing Address - Street 2:SUITE 155
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-1828
Mailing Address - Country:US
Mailing Address - Phone:703-921-0692
Mailing Address - Fax:
Practice Address - Street 1:6551 LOISDALE CT
Practice Address - Street 2:SUITE 155
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1828
Practice Address - Country:US
Practice Address - Phone:703-921-0692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010385592084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty