Basic Information
Provider Information
NPI: 1164867453
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WOODARD
FirstName: ALFLOYD
MiddleName:  
NamePrefix: DR.
NameSuffix: JR.
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2025 GLENN MITCHELL DR
Address2:  
City: VIRGINIA BEACH
State: VA
PostalCode: 234560178
CountryCode: US
TelephoneNumber: 7575074123
FaxNumber: 7572615849
Practice Location
Address1: 2025 GLENN MITCHELL DR
Address2:  
City: VIRGINIA BEACH
State: VA
PostalCode: 234560178
CountryCode: US
TelephoneNumber: 3027331042
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/01/2013
LastUpdateDate: 10/16/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000XC7-0005373DEN Allopathic & Osteopathic PhysiciansHospitalist 
208M00000X0101260895VAN Allopathic & Osteopathic PhysiciansHospitalist 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000X0101260895VAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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