Physician Compare National (NPI:1114120748)

HEALTHCARE PROVIDER: ERIN THOR WOLFF M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1114120748
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0840387270
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071101000624
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WOLFF
	Individual professional last name
Provider First Name	ERIN
	Individual professional first name
Provider Middle Name	T
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	SPORTS MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PHYSICAL MEDICINE AND REHABILITATION
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PHYSICAL MEDICINE AND REHABILITATION
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	730 COLLEGE ST
	Group Practice or individual's line 1 address
City	JACKSONVILLE
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	322043313
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y