Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 25690 | AZ |
NPI | 1376508697 |
---|---|
Provider Name | Dr. Michael Warren Wolff |
First Address | Scottsdale, AZ 85258-4586 |
Second Address | Scottsdale, AZ 85258-4586 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 15/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G54621 | (02) | AZ |