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NPI Code Detail

MEDICARE: DR. KATRINA MARIE LAWRENCE-WOLFF DO

MEDICARE: DR. KATRINA MARIE LAWRENCE-WOLFF DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician02004360AIN
2207RR0500XRheumatology Physician02004360AIN
3207RR0500XRheumatology Physician5101026699MI

General Provider Information

NPI Number : 1013283845
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATRINA MARIE LAWRENCE-WOLFF DO
Provider Business Mailing Address
First Line : 3537 W FRONT ST STE A
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-7942
Country : US
Telephone Number : 231-935-8330
Fax Number : 231-935-3437
Provider Business Practice Location Address
First Line : 3537 W FRONT ST STE A
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-7942
Country : US
Telephone Number : 231-935-8330
Fax Number : 231-935-3437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2012
Last Update Date : 04/25/2022

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