Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DS 2242 | TN |
NPI | 1144338542 |
---|---|
Provider Name | Steven A Wolf |
First Address | Nashville, TN 37212-3833 |
Second Address | Nashville, TN 37212-3833 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2006 |
Last Update Date | 08/07/2007 |