Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | D035010 | MD |
Y | 2081P2900X | Pain Medicine | D035010 | MD |
NPI | 1245226687 |
---|---|
Provider Name | Dr. Marcia Debra Wolf |
First Address | Ellicott City, MD 21042-7713 |
Second Address | Pikesville, MD 21208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 11/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020046614 | RAILROAD MEDICARE (01) | |
0W64MD | CAREFIRST BC/BS (01) | MD |
200704500 | (05) | MD |
277R | OLD MC (01) | MD |
E53355 | (02) | MD |
S1770001 | BLUE SHEILD NATIONAL CAPI (01) | DC |