Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 59346 | TN |
N | 2080P0203X | Pediatric Critical Care Doctor | 59346 | TN |
Y | 2080P0203X | Pediatric Critical Care Doctor | MD454173 | PA |
NPI | 1295097822 |
---|---|
Provider Name | Dr. Michael Seth Wolf |
First Address | Pittsburgh, PA 15217 |
Second Address | Pittsburgh, PA 15224-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2012 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
59346 | STATE MEDICAL LICENSE (01) | TN |