Provider Demographics
NPI:1700812500
Name:WOOD, TIMOTHY CARL (PHD, FACMG)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:CARL
Last Name:WOOD
Suffix:
Gender:M
Credentials:PHD, FACMG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 GREGOR MENDEL CIR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-2316
Mailing Address - Country:US
Mailing Address - Phone:864-941-8100
Mailing Address - Fax:
Practice Address - Street 1:125 GREGOR MENDEL CIR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-2316
Practice Address - Country:US
Practice Address - Phone:864-941-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2005190207SG0202X
SC2002126207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207SG0202XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Biochemical Genetics
Not Answered207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics