Provider Demographics
NPI:1487654695
Name:WOODS, MICHAEL P (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:WOODS
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 1:300 PERSHING AVE
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-2355
Mailing Address - Country:US
Mailing Address - Phone:712-246-1230
Mailing Address - Fax:712-246-7357
Practice Address - Street 1:300 PERSHING AVE
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-2355
Practice Address - Country:US
Practice Address - Phone:712-246-1230
Practice Address - Fax:712-246-7357
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27220207V00000X, 207VF0040X
NE17301207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2059832Medicaid
160035546OtherMEDICARE RR
NE91178487513Medicaid
NE91178487513Medicaid
160035546OtherMEDICARE RR
IA2059832Medicaid