Provider Demographics
NPI:1437276276
Name:WOODS, MATTHEW TRAVIS (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:TRAVIS
Last Name:WOODS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1688 E BOSTON ST
Mailing Address - Street 2:STE. 101
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-6221
Mailing Address - Country:US
Mailing Address - Phone:480-855-0085
Mailing Address - Fax:480-855-0086
Practice Address - Street 1:1688 E. BOSTON ST.,
Practice Address - Street 2:SUITE 101
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295
Practice Address - Country:US
Practice Address - Phone:480-855-0085
Practice Address - Fax:480-855-0086
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29461207N00000X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ757618Medicaid
AZ757618Medicaid