Provider Demographics
NPI:1609856426
Name:WOOD, TERRY D (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:D
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 IWILEI RD STE 210
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-5318
Mailing Address - Country:US
Mailing Address - Phone:808-871-1411
Mailing Address - Fax:808-871-1441
Practice Address - Street 1:33 LONO AVE STE 260
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1634
Practice Address - Country:US
Practice Address - Phone:808-871-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR176569207W00000X
CAC54832207W00000X
HIMD-21430207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H65361Medicare UPIN
OR207W00000XMedicare UPIN
VTVN3868Medicare ID - Type Unspecified