Provider Demographics
NPI:1154372043
Name:WOODS, THADDEUS DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:THADDEUS
Middle Name:DAVID
Last Name:WOODS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:900 SO 74 PLZ
Mailing Address - Street 2:SUITE 108
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4648
Mailing Address - Country:US
Mailing Address - Phone:402-391-3387
Mailing Address - Fax:402-391-7821
Practice Address - Street 1:7500 MERCY RD
Practice Address - Street 2:ALEGENT HEALTH BERGAN MERCY EMERGENCY DEPT
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124
Practice Address - Country:US
Practice Address - Phone:402-398-6161
Practice Address - Fax:402-398-6982
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE18506207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA3089490Medicaid
080106665OtherRAILROAD MEDICARE
NE47064207113Medicaid
E89096Medicare UPIN