Provider Demographics
NPI:1629046917
Name:WOOD, DAVID A JR (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:WOOD
Suffix:JR
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:974A SAXONBURG BLVD
Mailing Address - Street 2:
Mailing Address - City:SAXONBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16056-2318
Mailing Address - Country:US
Mailing Address - Phone:724-265-4065
Mailing Address - Fax:724-265-4056
Practice Address - Street 1:974A SAXONBURG BLVD
Practice Address - Street 2:
Practice Address - City:SAXONBURG
Practice Address - State:PA
Practice Address - Zip Code:16056-2318
Practice Address - Country:US
Practice Address - Phone:724-265-4065
Practice Address - Fax:724-265-4056
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN298327L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001881464Medicaid
PA001881464Medicaid
PA012937FEVMedicare ID - Type Unspecified