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General NPI Number Information
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NPI Number | 1518955400
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Entity Type | Individual
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Provider Name | NELSON WOLF MD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 3401 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5103
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Country | US
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Telephone | 215-707-5800
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Fax | 215-707-3946
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Provider Business Mailing Address
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Address Line | P.O BOX 8277783
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City | PHILADELPHIA
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State | PA
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Zip | 19185-7783
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Country | US
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Telephone | 215-707-5800
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Fax | 215-707-3946
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD011050E
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License Number State | PA
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