Provider Demographics
NPI:1518070317
Name:WOOD, TSEN S (MD)
Entity Type:Individual
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First Name:TSEN
Middle Name:S
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2200 LONG LAKE SHORES DR
Mailing Address - Street 2:
Mailing Address - City:W BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-1927
Mailing Address - Country:US
Mailing Address - Phone:248-334-6594
Mailing Address - Fax:248-477-4413
Practice Address - Street 1:36475 FIVE MILE RD
Practice Address - Street 2:ST MARY MERCY HOSPITAL
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154
Practice Address - Country:US
Practice Address - Phone:734-655-4800
Practice Address - Fax:734-655-1445
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301033148207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B49319Medicare UPIN