Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 0101041005 | VA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 0101041005 | VA |
NPI | 1316262124 |
---|---|
Provider Name | William B Wolf III |
First Address | Winchester, VA 22601-4158 |
Second Address | Middleburg, VA 20117-3425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2010 |
Last Update Date | 17/09/2020 |