Healthcare Provider Details

I. General information

NPI: 1316946346
Provider Name (Legal Business Name): ERIC ALLEN WOLFE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 EASTON RD SUITE 1
HELLERTOWN PA
18055-1502
US

IV. Provider business mailing address

725 EASTON RD SUITE 1
HELLERTOWN PA
18055-1502
US

V. Phone/Fax

Practice location:
  • Phone: 610-838-6808
  • Fax: 610-838-5333
Mailing address:
  • Phone: 610-838-6808
  • Fax: 610-838-5333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberSC003773-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: