Healthcare Provider Details

I. General information

NPI: 1306065677
Provider Name (Legal Business Name): MELVYN A. WOLF MDPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 SUMNEYTOWN PIKE SUITE 201
SPRING HOUSE PA
19477-1011
US

IV. Provider business mailing address

909 SUMNEYTOWN PIKE SUITE 201
SPRING HOUSE PA
19477-1011
US

V. Phone/Fax

Practice location:
  • Phone: 215-542-1522
  • Fax: 215-542-9609
Mailing address:
  • Phone: 215-542-1522
  • Fax: 215-542-9609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD010274E
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. MELVYN ARNOLD WOLF
Title or Position: PRESIDENT
Credential: MD
Phone: 215-542-1522