Provider Demographics
NPI:1992759013
Name:WOODARD, TERRI LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:TERRI
Middle Name:LYNN
Last Name:WOODARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TERRI
Other - Middle Name:LYNN
Other - Last Name:WOODARD OFORI-BOATENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3750 WOODWARD AVE
Mailing Address - Street 2:STE 200B
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2007
Mailing Address - Country:US
Mailing Address - Phone:313-993-4538
Mailing Address - Fax:313-993-4537
Practice Address - Street 1:6651 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2351
Practice Address - Country:US
Practice Address - Phone:832-826-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301087148207V00000X
TXP4530207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology