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NPI Code Detail

MEDICARE: PETER WOLFF M.D.

MEDICARE:   PETER  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
1208600000XSurgery PhysicianMD00025578WA
22086S0129XVascular Surgery PhysicianMD00022578WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2399073OTHERWALABOR & INDUSTRIES

General Provider Information

NPI Number : 1447258801
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER WOLFF M.D.
Provider Business Mailing Address
First Line : 1400 E KINCAID ST
Second Line : ATTN: CREDENTIALING
City : MOUNT VERNON
State : WA
Zip : 98274-4127
Country : US
Telephone Number : 360-428-2500
Fax Number : 360-428-6485
Provider Business Practice Location Address
First Line : 875 WESLEY ST STE 230
Second Line :
City : ARLINGTON
State : WA
Zip : 98223-1668
Country : US
Telephone Number : 360-435-6097
Fax Number : 360-435-1871
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 01/17/2022

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Directions to “ PETER WOLFF M.D.” Practice Location

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