Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | D90683 | MD |
N | 208200000X | Surgeon | MT212067 | PA |
N | 208600000X | Surgeon | MT212067 | PA |
NPI | 1003295445 |
---|---|
Provider Name | Dr. Samantha A Wolfe |
First Address | Middle River, MD 21220-2004 |
Second Address | Baltimore, MD 21224-2735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2015 |
Last Update Date | 29/05/2021 |