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NPI Code Detail

MEDICARE: SHANNAN D. WOLFF

MEDICARE: SHANNAN D. WOLFF
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1700492709
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNAN D. WOLFF
Provider Business Mailing Address
First Line : 9500 DETROIT AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-1852
Country : US
Telephone Number : 216-283-4400
Fax Number :
Provider Business Practice Location Address
First Line : 9500 DETROIT AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-1852
Country : US
Telephone Number : 216-283-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2020
Last Update Date : 09/16/2020

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Directions to “ SHANNAN D. WOLFF ” Practice Location

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