Provider Demographics
NPI:1548377328
Name:KAMATH-WOOD, CLARA (MD)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:KAMATH-WOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3272
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48605-3272
Mailing Address - Country:US
Mailing Address - Phone:989-797-1400
Mailing Address - Fax:989-797-4077
Practice Address - Street 1:18245 E 10 MILE RD STE 120
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-5807
Practice Address - Country:US
Practice Address - Phone:586-265-2680
Practice Address - Fax:586-265-2240
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301064612207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3390518Medicaid
MI3390518Medicaid
G59282Medicare UPIN