Provider Demographics
NPI:1871588863
Name:WOODRUFF, TODD EDWARD (MD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:EDWARD
Last Name:WOODRUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 PARK WEST BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-4218
Mailing Address - Country:US
Mailing Address - Phone:330-836-8545
Mailing Address - Fax:330-836-8598
Practice Address - Street 1:1 PARK WEST BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4218
Practice Address - Country:US
Practice Address - Phone:330-836-8545
Practice Address - Fax:330-836-8598
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2011-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35050864W207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0557651Medicaid
A15755Medicare UPIN