Provider Demographics
NPI:1215921432
Name:WOODRUFF, BRIAN ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ERIC
Last Name:WOODRUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 HOUGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-5303
Mailing Address - Country:US
Mailing Address - Phone:899-746-7500
Mailing Address - Fax:
Practice Address - Street 1:1000 HOUGHTON AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-5303
Practice Address - Country:US
Practice Address - Phone:899-746-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077699208000000X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0997882OtherHEALTH PLUS
MI16565OtherMCARE
MI2239600OtherFIRST HEALTH
MI32984OtherHEALTH PLAN OF MI
MIP32884FOtherBLUE CARE NETWORK
MI0520016OtherPHP
MA149544OtherGREAT LAKES MEDICAID
MIH53465Medicare ID - Type Unspecified
MI138673OtherPREFERRED CHOICES
MI9454809OtherCIGNA
MI412228455OtherTRICARE
MI7210543OtherAETNA
MI35081456502OtherBCBSM
MI104995137Medicaid
MIP49360001Medicare PIN
MI028005OtherMIDWEST (HVPA)
MI412228455OtherCOFINITY
MIH53465Medicare UPIN