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General NPI Number Information
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NPI Number | 1811973332
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Entity Type | Individual
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Provider Name | DAVID WOLPAW MD
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Gender | Male
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Dates
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Enumeration Date | 12/16/2005
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 256 N MAIN ST
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City | MANCHESTER
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State | CT
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Zip | 06042-2004
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Country | US
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Telephone | 860-646-8595
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Fax | 860-645-3216
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Provider Business Mailing Address
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Address Line | 256 N MAIN ST
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City | MANCHESTER
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State | CT
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Zip | 06042-2004
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Country | US
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Telephone | 860-646-8595
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Fax | 860-645-3216
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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 | 040883
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License Number State | CT
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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 | 40883
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License Number State | CT
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