MEDICARE: ALAMANCE UROLOGICAL, P.C.

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
1	208800000X	Urology Physician		NC

General Provider Information

NPI Number	:	1043579337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAMANCE UROLOGICAL, P.C.

Provider Business Mailing Address
First Line	:	841 HEATHER RD
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-6288
Country	:	US
Telephone Number	:	336-227-2761
Fax Number	:	336-227-4242

Provider Business Practice Location Address
First Line	:	841 HEATHER RD
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-6288
Country	:	US
Telephone Number	:	336-227-2761
Fax Number	:	336-227-4242

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL R WOLFF
Credential	:	M.D.
Telephone Number	:	336-227-2761

Provider Enumeration Date	:	05/08/2012
Last Update Date	:	05/08/2012

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