Provider Demographics
NPI:1922014778
Name:DR NORMAN E WOOD INC
Entity Type:Organization
Organization Name:DR NORMAN E WOOD INC
Other - Org Name:DOCTORS URGENT CARE AND FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:301-359-2292
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:90 MAIN ST.
Mailing Address - City:WESTERNPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21562
Mailing Address - Country:US
Mailing Address - Phone:301-359-2295
Mailing Address - Fax:301-359-2295
Practice Address - Street 1:90 MAIN ST.
Practice Address - Street 2:
Practice Address - City:WESTERNPORT
Practice Address - State:MD
Practice Address - Zip Code:21562
Practice Address - Country:US
Practice Address - Phone:301-359-2292
Practice Address - Fax:301-359-2295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0056000207Q00000X
MDH56000207Q00000X
MDH5600208000000X
WV1680261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD056200900Medicaid
MD180NMedicare PIN
MDH32903Medicare UPIN