Provider Demographics
NPI:1811058381
Name:WOODYARD, JANET P (MD)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:P
Last Name:WOODYARD
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 1:20 CROSSROADS DR
Mailing Address - Street 2:SUITE 12
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5419
Mailing Address - Country:US
Mailing Address - Phone:410-363-9000
Mailing Address - Fax:410-363-9380
Practice Address - Street 1:20 CROSSROADS DR
Practice Address - Street 2:SUITE 12
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5419
Practice Address - Country:US
Practice Address - Phone:410-363-9000
Practice Address - Fax:410-363-9380
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00342092086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCA801 0001OtherCAREFIRST
GAP00699508OtherRAILROAD MEDICARE
MDA801 0001OtherCAREFIRST
MD130043ZAEROtherMEDICARE