Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 001353 | GA |
Y | 2084N0402X | Child Neurologist | D0071070 | MD |
NPI | 1255534228 |
---|---|
Provider Name | Dr. David Scott Wolf |
First Address | Baltimore, MD 21287-0006 |
Second Address | Baltimore, MD 21287-0006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 11/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036098800 | (05) | MD |