Provider Demographics
NPI:1245351634
Name:WOOD, ROBERT H (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
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:PO BOX 8500-9292
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-9292
Mailing Address - Country:US
Mailing Address - Phone:609-815-7810
Mailing Address - Fax:609-815-7814
Practice Address - Street 1:ONE CAPITAL WAY
Practice Address - Street 2:PATHOLOGY DEPARTMENT
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2519
Practice Address - Country:US
Practice Address - Phone:609-303-4019
Practice Address - Fax:609-394-4685
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03944000207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2169401Medicaid
NJD19423Medicare UPIN
NJ2169401Medicaid