Provider Demographics
NPI:1982704359
Name:WOODY, MATTHEW B (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:B
Last Name:WOODY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2700 CLAY EDWARDS DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:N KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3251
Mailing Address - Country:US
Mailing Address - Phone:816-455-0681
Mailing Address - Fax:816-455-5294
Practice Address - Street 1:2700 CLAY EDWARDS DR
Practice Address - Street 2:SUITE 240
Practice Address - City:N KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3251
Practice Address - Country:US
Practice Address - Phone:816-455-0681
Practice Address - Fax:816-455-5294
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2017-04-18
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Provider Licenses
StateLicense IDTaxonomies
MO100786208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1982704359Medicaid
MO1982704359Medicaid
MOMA6411019Medicare PIN