MEDICARE: MERVIN GARY WOLFF 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
1	207R00000X	Internal Medicine Physician	MW046725	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1108211832	OTHER	MI	BCBS PROVIDER NO.

General Provider Information

NPI Number	:	1154411213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERVIN GARY WOLFF M.D.

Provider Business Mailing Address
First Line	:	3011 W GRAND BLVD STE 210
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-3068
Country	:	US
Telephone Number	:	313-871-7572
Fax Number	:	313-871-7573

Provider Business Practice Location Address
First Line	:	3011 W GRAND BLVD STE 210
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-3068
Country	:	US
Telephone Number	:	313-871-7572
Fax Number	:	313-871-7573

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1841621018 — ADDUS HEALTHCARE, INC.
Practice Location Address:

3011 W GRAND BLVD STE 206
DETROIT, MI
48202-3068

Practice Phone: 313-309-2999
Practice Fax: 877-592-0262

1154855443 — GAREN WOLFF
Practice Location Address:

3011 W GRAND BLVD STE 210
DETROIT, MI
48202-3068

Practice Phone: 313-871-7572
Practice Fax: 313-789-1714

1689333080 — WOLFFALLERGYASTHMA PLLC
Practice Location Address:

3011 W GRAND BLVD STE 210
DETROIT, MI
48202-3068

Practice Phone: 313-871-7572
Practice Fax:

1306592100 — WOLFFINTERNALMEDICINE PLLC
Practice Location Address:

3011 W GRAND BLVD STE 210
DETROIT, MI
48202-3068

Practice Phone: 313-871-7572
Practice Fax: 313-871-7573

1265003024 — MELISSA LONGTINE LPCC
Practice Location Address:

808 WASHINGTON AVE STE 22D
DETROIT LAKES, MN
56501-3068

Practice Phone: 218-849-7524
Practice Fax:

1407693237 — MS. EBONY WHISENTON
Practice Location Address:

17664 FENTON ST
DETROIT, MI
48219-3068

Practice Phone: 216-645-3006
Practice Fax:

Directions to “ MERVIN GARY WOLFF M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.