Healthcare Provider Details

I. General information

NPI: 1093178709
Provider Name (Legal Business Name): CHRISTOPHER WOLF DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 12/30/2021
Certification Date: 12/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 CAREW STREET #250
SPRINGFIELD MA
01104
US

IV. Provider business mailing address

175 CAREW ST STE 250
SPRINGFIELD MA
01104-2483
US

V. Phone/Fax

Practice location:
  • Phone: 413-748-7350
  • Fax: 413-748-7325
Mailing address:
  • Phone: 413-748-7350
  • Fax: 413-748-7325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2492
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: