Provider Demographics
NPI:1457328981
Name:UNDERWOOD, NED ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:NED
Middle Name:ALAN
Last Name:UNDERWOOD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 CHURCHILL HUBBARD RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1368
Mailing Address - Country:US
Mailing Address - Phone:330-759-8097
Mailing Address - Fax:330-759-3212
Practice Address - Street 1:214 CHURCHILL HUBBARD RD
Practice Address - Street 2:SUITE A
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1368
Practice Address - Country:US
Practice Address - Phone:330-759-8097
Practice Address - Fax:330-759-3212
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002099U207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0255021Medicaid
D89530Medicare UPIN
UN0402934Medicare ID - Type Unspecified