Provider Demographics
NPI:1467655712
Name:WOOD, MATHEW J (DO)
Entity Type:Individual
Prefix:
First Name:MATHEW
Middle Name:J
Last Name:WOOD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2108 LUMBER AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5350
Mailing Address - Country:US
Mailing Address - Phone:304-780-6958
Mailing Address - Fax:888-267-0548
Practice Address - Street 1:2108 LUMBER AVE STE 6
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-5350
Practice Address - Country:US
Practice Address - Phone:304-780-6958
Practice Address - Fax:888-267-0548
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2012-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WVWV2255207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine