MEDICARE: DR. MICHAEL RICHARD 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
1	208800000X	Urology Physician	32600	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	211664B	OTHER	NC	PSC MEDICARE PROVIDER #
3	230130	OTHER	NC	MEDICARE GROUP #

Other Identifiers

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

General Provider Information

NPI Number	:	1902975428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL RICHARD WOLFF M.D.

Provider Business Mailing Address
First Line	:	841 HEATHER RD
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-6288
Country	:	US
Telephone Number	:	336-229-7776
Fax Number	:	336-227-4242

Provider Business Practice Location Address
First Line	:	841 HEATHER RD
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-6288
Country	:	US
Telephone Number	:	336-229-7776
Fax Number	:	336-227-4242

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	10/05/2016

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