Provider Demographics
NPI:1629235551
Name:JANET P WOODYARD MD LLC
Entity Type:Organization
Organization Name:JANET P WOODYARD MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:P
Authorized Official - Last Name:WOODYARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-363-9000
Mailing Address - Street 1:20 CROSSROADS DR
Mailing Address - Street 2:SUITE 12
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5419
Mailing Address - Country:US
Mailing Address - Phone:410-363-9000
Mailing Address - Fax:410-363-9380
Practice Address - Street 1:20 CROSSROADS DR
Practice Address - Street 2:SUITE 12
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5419
Practice Address - Country:US
Practice Address - Phone:410-363-9000
Practice Address - Fax:410-363-9380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADO6928OtherRAILROAD MEDICARE
MD129986OtherMEDICARE
DCA801 0001OtherCAREFIRST
MDA801 0001OtherCAREFIRST