Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 34643 | CO |
NPI | 1285698886 |
---|---|
Provider Name | Dr. Tracy M Wolf |
First Address | Westminster, CO 80023-9328 |
Second Address | Westminster, CO 80023-9328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 16/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1346436 | (05) | CO |
400000680 | RAILROAD MEDICARE (01) | CO |
G65963 | (02) | CO |