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General NPI Number Information
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NPI Number | 1003985292
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Entity Type | Organization
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Legal Business Name | NOALL E WOLFF MD
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/29/2011
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Provider Practice Location Address
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Address Line | 465 WASHINGTON ST
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City | MONTPELIER
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State | ID
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Zip | 83254-1544
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Country | US
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Telephone | 208-847-2878
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Fax | 208-847-2340
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Provider Business Mailing Address
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Address Line | 465 WASHINGTON ST
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City | MONTPELIER
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State | ID
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Zip | 83254-1544
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Country | US
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Telephone | 208-847-2878
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Fax | 208-847-2340
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Authorized Official
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Title or Position | PHYSICIAN
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Name | NOALL E WOLFF
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Credential | MD
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Telephone | 208-847-2878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M3599
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License Number State | ID
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