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General NPI Number Information
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NPI Number | 1073546180
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Entity Type | Organization
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Legal Business Name | MARIE C WOLFGANG MD
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 12/03/2009
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Provider Practice Location Address
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Address Line | 1 CEDAR AVE
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City | SEAFORD
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State | DE
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Zip | 19973-3300
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Country | US
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Telephone | 302-629-2366
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Fax | 302-629-6570
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Provider Business Mailing Address
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Address Line | 1 CEDAR AVE
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City | SEAFORD
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State | DE
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Zip | 19973-3300
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Country | US
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Telephone | 302-629-2366
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Fax | 302-629-6570
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | MARIE C WOLFGANG
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Credential | MD
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Telephone | 302-629-2366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C1-0003884
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License Number State | DE
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