Provider Demographics
NPI:1720123789
Name:WOOD HARPER, DEIRDRE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEIRDRE
Middle Name:
Last Name:WOOD HARPER
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 1:8001 ROOSEVELT BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-3038
Mailing Address - Country:US
Mailing Address - Phone:267-731-1333
Mailing Address - Fax:267-731-1284
Practice Address - Street 1:8001 ROOSEVELT BLVD
Practice Address - Street 2:SUITE 307
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3038
Practice Address - Country:US
Practice Address - Phone:267-731-1333
Practice Address - Fax:267-731-1284
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071508L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00471560Medicare PIN
PA049272R4TMedicare PIN
H42982Medicare UPIN
PA073707Medicare PIN
PA049272V4BMedicare PIN