Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 25MA06195800 | NJ |
Y | 2084N0400X | Neurologist | MD048939L | PA |
NPI | 1003872912 |
---|---|
Provider Name | Dr. William R. Wolfe |
First Address | Voorhees, NJ 08043 |
Second Address | Voorhees, NJ 08043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 27/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G06834 | (02) | NJ |