Provider Demographics
NPI:1407052996
Name:WOOD, MEGAN DANIELLE (MD)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:DANIELLE
Last Name:WOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:DANIELLE
Other - Last Name:VANDERLINDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 15TH ST N
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:IA
Mailing Address - Zip Code:50548-1008
Mailing Address - Country:US
Mailing Address - Phone:515-332-2015
Mailing Address - Fax:515-332-4211
Practice Address - Street 1:1010 15TH ST N
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:IA
Practice Address - Zip Code:50548-1008
Practice Address - Country:US
Practice Address - Phone:515-332-2015
Practice Address - Fax:515-332-4211
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME112263207RE0101X
IAMD43312207RE0101X
IA43312207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGF886ZMedicare PIN