Healthcare Provider Details

I. General information

NPI: 1255337168
Provider Name (Legal Business Name): DAVID L WOLFE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 03/07/2023
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N 7TH ST STE 200
CHAMBERSBURG PA
17201-1795
US

IV. Provider business mailing address

785 5TH AVE STE 3
CHAMBERSBURG PA
17201-4232
US

V. Phone/Fax

Practice location:
  • Phone: 717-217-6800
  • Fax:
Mailing address:
  • Phone: 717-263-9555
  • Fax: 717-709-6529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA002200L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA002200L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: