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General NPI Number Information
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NPI Number | 1629055520
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Entity Type | Individual
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Provider Name | KARYN ELIZABETH WOLFE M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 09/29/2012
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Provider Practice Location Address
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Address Line | 1011 E JEFFERSON ST
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-5354
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Country | US
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Telephone | 434-296-9161
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Fax | 434-296-1036
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Provider Business Mailing Address
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Address Line | 2300 HARTLAND CT
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-2216
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Country | US
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Telephone | 434-962-4667
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101238183
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License Number State | VA
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