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General NPI Number Information
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NPI Number | 1245226687
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Entity Type | Individual
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Provider Name | MARCIA DEBRA WOLF M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/21/2005
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 19 WALKER AVE SUITE 101
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City | PIKESVILLE
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State | MD
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Zip | 21208
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Country | US
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Telephone | 443-213-8812
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Fax | 443-213-8813
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Provider Business Mailing Address
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Address Line | 4725 DORSEY HALL DR SUITE A903
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-7713
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Country | US
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Telephone | 443-213-8812
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Fax | 443-213-8813
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | D035010
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | D035010
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | D035010
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | D035010
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License Number State | MD
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