Basic Information
| Provider Information | |||||||||
| NPI: | 1073256145 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CLARA KAMATH-WOOD MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3272 | ||||||||
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| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486053272 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897971400 | ||||||||
| FaxNumber: | 9897974077 | ||||||||
| Practice Location | |||||||||
| Address1: | 18245 E 10 MILE RD STE 120 | ||||||||
| Address2: | |||||||||
| City: | ROSEVILLE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480665807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5862652680 | ||||||||
| FaxNumber: | 5862652240 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2022 | ||||||||
| LastUpdateDate: | 10/17/2022 | ||||||||
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| AuthorizedOfficialLastName: | KAMATH-WOOD | ||||||||
| AuthorizedOfficialFirstName: | CLARA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5862652680 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 10/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.