Provider Demographics
NPI:1841431756
Name:WOODWARD, MEGAN JENNIFER (MD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JENNIFER
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:JENNIFER
Other - Last Name:LANDERHOLM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 PERKINS SQ
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1063
Mailing Address - Country:US
Mailing Address - Phone:330-823-7311
Mailing Address - Fax:330-823-6344
Practice Address - Street 1:1826 S ARCH AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4332
Practice Address - Country:US
Practice Address - Phone:330-823-7311
Practice Address - Fax:330-823-6344
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.096374208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0065803Medicaid