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NPI Code Detail

MEDICARE: DR. ANTHONY JOHN WOLF M.D.

MEDICARE: DR. ANTHONY JOHN WOLF M.D.
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
12084P0800XPsychiatry Physician4301085709MI

General Provider Information

NPI Number : 1033233838
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTHONY JOHN WOLF M.D.
Provider Business Mailing Address
First Line : 7590 GREENE FARM DR
Second Line :
City : YPSILANTI
State : MI
Zip : 48197-9467
Country : US
Telephone Number : 734-255-8721
Fax Number :
Provider Business Practice Location Address
First Line : 2395 OAK VALLEY DR STE 100
Second Line :
City : ANN ARBOR
State : MI
Zip : 48103-8943
Country : US
Telephone Number : 734-255-8721
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 12/23/2009

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