Healthcare Provider Details

I. General information

NPI: 1376508697
Provider Name (Legal Business Name): MICHAEL WARREN WOLFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9913 N 95TH ST
SCOTTSDALE AZ
85258-4586
US

IV. Provider business mailing address

9913 N 95TH ST
SCOTTSDALE AZ
85258-4586
US

V. Phone/Fax

Practice location:
  • Phone: 480-860-8998
  • Fax: 480-377-9245
Mailing address:
  • Phone: 480-860-8998
  • Fax: 480-377-9245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number25690
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: