Provider Demographics
NPI:1598754475
Name:WOODS, DEIDRA EVANS (MD)
Entity Type:Individual
Prefix:DR
First Name:DEIDRA
Middle Name:EVANS
Last Name:WOODS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5709 HARWICK RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2049
Mailing Address - Country:US
Mailing Address - Phone:301-229-9810
Mailing Address - Fax:
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:STE 1400
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-656-9170
Practice Address - Fax:301-654-5893
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD30748207RI0200X
MDD0054241207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
007932K02Medicare ID - Type Unspecified
G84450Medicare UPIN