Provider Demographics
NPI:1649438318
Name:WOOD, ALLISON LEIGH (DO MPH)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:LEIGH
Last Name:WOOD
Suffix:
Gender:F
Credentials:DO MPH
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Mailing Address - Street 1:4136 LEGACY PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4265
Mailing Address - Country:US
Mailing Address - Phone:517-999-5300
Mailing Address - Fax:517-999-5310
Practice Address - Street 1:4136 LEGACY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4265
Practice Address - Country:US
Practice Address - Phone:517-999-5300
Practice Address - Fax:517-999-5310
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2017-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVDO1449207R00000X
MI5101018021207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVBV646ZMedicare PIN
NVBV646YMedicare PIN