Active NPI
William Wood, M. D.
- Internal Medicine Physician
- Bangor, ME
National Provider Identifier
1215907308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD11750
- Practice address
- 900 Broadway
Bangor, ME 04401-1900 - Phone
- (207) 907-3300
- Fax
- (207) 907-1923
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD11750 | ME | Primary |
Addresses
Primary practice location
900 Broadway
Bangor, ME 04401-1900
Mailing address
222 Kenduskeag Ave
Bangor, ME 04401-3810
Other practice location 1
222 Kenduskeag Ave
Bangor, ME 04401-3810
Phone (207) 992-3160
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00210032 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD11750 | ME | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1215907308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 KENDUSKEAG AVE",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 BROADWAY",
"city": "BANGOR",
"state": "ME",
"postal_code": "044011900",
"telephone_number": "207-907-3300",
"fax_number": "207-907-1923"
}
],
"practiceLocations": [
{
"address_1": "222 Kenduskeag Ave",
"address_purpose": "LOCATION",
"city": "Bangor",
"state": "ME",
"postal_code": "044013810",
"country_code": "US",
"telephone_number": "207-992-3160",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOOD",
"first_name": "WILLIAM",
"credential": "M. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "ME",
"license": "MD11750",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00210032",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.