Provider Demographics
NPI:1396764296
Name:WOODS, SHEILA HOWELL (MD)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:HOWELL
Last Name:WOODS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E BUTLER RD STE C1
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-2170
Mailing Address - Country:US
Mailing Address - Phone:864-305-1662
Mailing Address - Fax:864-603-2067
Practice Address - Street 1:211 E. BUTLER RD.
Practice Address - Street 2:SUITE C1
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662
Practice Address - Country:US
Practice Address - Phone:864-305-1662
Practice Address - Fax:864-603-2067
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20815208000000X
SC32230208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64208150Medicaid
SC132234Medicaid
SC1305C632OtherPTAN
AW9359907OtherDEA
AW9359907OtherDEA
0054720Medicare ID - Type Unspecified