Provider Demographics
NPI:1225040645
Name:WOOD, GREGORY DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DOUGLAS
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 LONDONDERRY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5333
Mailing Address - Country:US
Mailing Address - Phone:717-652-6605
Mailing Address - Fax:717-652-6431
Practice Address - Street 1:4310 LONDONDERRY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5333
Practice Address - Country:US
Practice Address - Phone:717-652-6605
Practice Address - Fax:717-652-6431
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2280207V00000X
PAMD480173207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR139013001Medicaid
AR5L366Medicare ID - Type Unspecified
AR139013001Medicaid