Basic Information
Provider Information
NPI: 1093910788
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WOO
FirstName: GREGORY
MiddleName: WEI CHIANG
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7 GOODRICH RD
Address2:  
City: STURBRIDGE
State: MA
PostalCode: 015661140
CountryCode: US
TelephoneNumber: 5089417000
FaxNumber: 5089416480
Practice Location
Address1: 680 CENTRE ST
Address2:  
City: BROCKTON
State: MA
PostalCode: 023023308
CountryCode: US
TelephoneNumber: 5089417000
FaxNumber: 5089416480
Other Information
ProviderEnumerationDate: 06/20/2007
LastUpdateDate: 08/31/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X248062MAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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