Provider Demographics
NPI:1053761569
Name:WOIDA, HENRY WILLIAM (PA-C)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:WILLIAM
Last Name:WOIDA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4293 N HURON RD
Mailing Address - Street 2:
Mailing Address - City:PINCONNING
Mailing Address - State:MI
Mailing Address - Zip Code:48650-8402
Mailing Address - Country:US
Mailing Address - Phone:989-879-6244
Mailing Address - Fax:989-879-1092
Practice Address - Street 1:720 W WACKERLY ST
Practice Address - Street 2:STE. 8
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2769
Practice Address - Country:US
Practice Address - Phone:989-486-9500
Practice Address - Fax:989-486-9503
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601007761363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical