Provider Demographics
NPI:1154382901
Name:INWOOD, MARY LOUISE (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:LOUISE
Last Name:INWOOD
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 1:1184 W LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-2009
Mailing Address - Country:US
Mailing Address - Phone:937-382-1616
Mailing Address - Fax:937-382-7877
Practice Address - Street 1:1184 W LOCUST ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-2009
Practice Address - Country:US
Practice Address - Phone:937-382-1616
Practice Address - Fax:937-382-7877
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35058057207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0735593Medicaid
OH0735593Medicaid
OHIN0631952Medicare PIN
OHE02310Medicare UPIN
OH110091420Medicare PIN
OH7143541Medicare PIN