Provider Demographics
NPI:1437183704
Name:WOOD, JOHN M (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:WOOD
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 1:100 DELAFIELD RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3247
Mailing Address - Country:US
Mailing Address - Phone:412-784-1110
Mailing Address - Fax:412-784-1181
Practice Address - Street 1:100 DELAFIELD RD
Practice Address - Street 2:SUITE 307
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3247
Practice Address - Country:US
Practice Address - Phone:412-784-1110
Practice Address - Fax:412-784-1181
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019352E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000762271Medicaid
PAWO058824Medicare ID - Type Unspecified
C28580Medicare UPIN