Healthcare Provider Details

I. General information

NPI: 1386330165
Provider Name (Legal Business Name): TRENTON WOLFE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TRENTON WOLFE DPM

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 10/26/2026
Certification Date: 10/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 MICHIGAN ST STE 100
SIDNEY OH
45365-2401
US

IV. Provider business mailing address

915 MICHIGAN ST
SIDNEY OH
45365-2401
US

V. Phone/Fax

Practice location:
  • Phone: 937-419-8049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.004181
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: