Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | MD022361E | PA |
N | 207ND0900X | Dermatopathologist | MD022361E | PA |
N | 207NS0135X | Procedural Dermatology | MD022361E | PA |
NPI | 1528008059 |
---|---|
Provider Name | Dr. Jeffrey Moyer Wolff |
First Address | Manitowoc, WI 54220-4630 |
Second Address | Greensburg, PA 15601-2211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 24/02/2021 |