Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 1531 | TN |
NPI | 1013980556 |
---|---|
Provider Name | Steven D Wolf |
First Address | Cleveland, TN 37311-3863 |
Second Address | Cleveland, TN 37311-3863 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 09/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3814231 | (05) | TN |
A16464 | (02) | TN |