Basic Information
Provider Information
NPI: 1952493728
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WOODS
FirstName: DONALD
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3605 WARRENSVILLE CENTER RD
Address2:  
City: SHAKER HEIGHTS
State: OH
PostalCode: 441225203
CountryCode: US
TelephoneNumber: 2162866260
FaxNumber: 2162866341
Practice Location
Address1: 11100 EUCLID AVE
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441061716
CountryCode: US
TelephoneNumber: 2168443771
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/29/2006
LastUpdateDate: 05/20/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X35-086990OHN Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900X35-086990OHY Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

ID Information
IDTypeStateIssuerDescription
058332801OHBCMHOTHER
P0035887601OHMEDICARE RAILROADOTHER
36414801OHWELLCARE MEDICAIDOTHER
772685901OHAETNAOTHER
00000050365201OHANTHEMOTHER
00000022116001OHUNISONOTHER
74416701OHBUCKEYE MEDICAIDOTHER
268099705OH MEDICAID


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