Provider Demographics
NPI:1841249901
Name:WOODWARD, RALPH ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:ANDREW
Last Name:WOODWARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:304 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2836
Mailing Address - Country:US
Mailing Address - Phone:307-237-5478
Mailing Address - Fax:307-237-5575
Practice Address - Street 1:304 S PARK ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2836
Practice Address - Country:US
Practice Address - Phone:307-237-5478
Practice Address - Fax:307-237-5575
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY5447A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYG29870Medicare UPIN