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NPI Code Detail

MEDICARE: DR. LARRY HOWARD WOLFF M.D.

MEDICARE:  DR. LARRY HOWARD WOLFF  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician01026837IN

General Provider Information

NPI Number : 1417950619
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY HOWARD WOLFF M.D.
Provider Business Mailing Address
First Line : 1620 COUNTRY CLUB RD
Second Line : SUITE D
City : VALPARAISO
State : IN
Zip : 46383-2251
Country : US
Telephone Number : 219-462-0309
Fax Number : 219-464-4291
Provider Business Practice Location Address
First Line : 701 SUPERIOR AVE
Second Line : SUITE A
City : MUNSTER
State : IN
Zip : 46321-4037
Country : US
Telephone Number : 219-934-0150
Fax Number : 219-934-0152
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 07/08/2007

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Directions to “ DR. LARRY HOWARD WOLFF M.D.” Practice Location

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