Provider Demographics
NPI:1386677912
Name:WOODDELL, MARGARET K (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:K
Last Name:WOODDELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 O ST STE 210B
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-5224
Mailing Address - Country:US
Mailing Address - Phone:916-442-1011
Mailing Address - Fax:916-492-0169
Practice Address - Street 1:2000 O ST STE 210B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5224
Practice Address - Country:US
Practice Address - Phone:916-442-1011
Practice Address - Fax:916-492-0169
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG074567207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G745870Medicaid
CAF66552Medicare UPIN
CA00G745870Medicare PIN