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General NPI Number Information
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NPI Number | 1659305506
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Entity Type | Individual
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Provider Name | THOMAS A WOLF MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 350 W 23RD ST STE A
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City | FREMONT
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State | NE
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Zip | 68025-2592
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Country | US
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Telephone | 402-721-7077
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Fax | 402-753-6056
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Provider Business Mailing Address
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Address Line | PO BOX 11724
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City | BELFAST
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State | ME
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Zip | 04915-4008
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Country | US
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Telephone | 402-721-7077
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Fax | 402-753-6056
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23824
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0430314
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License Number State | KS
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