MEDICARE: DR. ARNOLD BRYAN WOLF DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	5901001164	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00292814	OTHER	MI	RAILROAD MEDICARE PART B

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	480E021060	OTHER	MI	BCBSM
3	104435	OTHER	MI	GREAT LAKES HEALTH ID
4	870453	OTHER	MI	UNITED HEALTHCARE ID
5	4885050380	OTHER	MI	BCBS ID
6	83069B	OTHER	MI	HAP ID
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	AW001164	OTHER	MI	STATE LICENSE
9	382637930	OTHER	MI	TAX ID
10	4662672	OTHER	MI	AETNA ID
11	C7479	OTHER	MI	M CARE ID

General Provider Information

NPI Number	:	1124020847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARNOLD BRYAN WOLF DPM

Provider Business Mailing Address
First Line	:	13811 19 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-2705
Country	:	US
Telephone Number	:	586-247-0840
Fax Number	:	586-247-7668

Provider Business Practice Location Address
First Line	:	13811 19 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-2705
Country	:	US
Telephone Number	:	586-247-0840
Fax Number	:	586-247-7668

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	10/05/2023

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