Healthcare Provider Details

I. General information

NPI: 1316131972
Provider Name (Legal Business Name): KATHERINE BRIDGET WOLFE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE BRIDGET MCGOLDRICK

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 EASTLAND AVE SE STE 302
WARREN OH
44484-4501
US

IV. Provider business mailing address

627 EASTLAND AVE SE STE 302
WARREN OH
44484-4501
US

V. Phone/Fax

Practice location:
  • Phone: 330-841-4975
  • Fax: 330-841-4979
Mailing address:
  • Phone: 330-841-4975
  • Fax: 330-841-4979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number34.009547
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: