Provider Demographics
NPI:1932471679
Name:NED A UNDERWOOD DO INC
Entity Type:Organization
Organization Name:NED A UNDERWOOD DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NED
Authorized Official - Middle Name:A
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-759-8097
Mailing Address - Street 1:214 CHURCHILL HUBBARD RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1368
Mailing Address - Country:US
Mailing Address - Phone:330-759-8097
Mailing Address - Fax:330-759-3212
Practice Address - Street 1:214 CHURCHILL HUBBARD RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1368
Practice Address - Country:US
Practice Address - Phone:330-759-8097
Practice Address - Fax:330-759-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002099U207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty