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NPI Code Detail

MEDICARE: DR. ANDREA C WOLFE MD

MEDICARE:  DR. ANDREA C WOLFE  MD
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
1207V00000XObstetrics & Gynecology Physician4301076695MI

General Provider Information

NPI Number : 1043214794
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREA C WOLFE MD
Provider Business Mailing Address
First Line : 329 SADDLEBACK DR NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49525-3493
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 329 SADDLEBACK DR NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49525-3493
Country : US
Telephone Number : 616-486-6790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 05/04/2015

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Directions to “ DR. ANDREA C WOLFE MD” Practice Location

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