MEDICARE: DR. AMIR H. WOLFE M.D., MPH

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	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	4301080853	MI

General Provider Information

NPI Number	:	1336340322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMIR H. WOLFE M.D., MPH

Provider Business Mailing Address
First Line	:	22402 CHATSFORD CIRCUIT ST
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48034-6240
Country	:	US
Telephone Number	:	248-350-3503
Fax Number	:

Provider Business Practice Location Address
First Line	:	39000 MOUND RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-2733
Country	:	US
Telephone Number	:	586-826-5744
Fax Number	:	586-826-5430

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

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	07/08/2007

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