MEDICARE: DR. TODD E WOLF 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	207RH0003X	Hematology & Oncology Physician	0101232603	VA
2	207RH0003X	Hematology & Oncology Physician	MD462220	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00252676	OTHER	VA	MEDICARE RAILROAD

General Provider Information

NPI Number	:	1619952462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD E WOLF M.D.

Provider Business Mailing Address
First Line	:	500 UNIVERSITY DR MC CA410
Second Line	:
City	:	HERSHEY
State	:	PA
Zip	:	17033-2360
Country	:	US
Telephone Number	:	717-531-5208
Fax Number	:	717-531-0119

Provider Business Practice Location Address
First Line	:	2221 NOLL DR
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-7614
Country	:	US
Telephone Number	:	717-735-3738
Fax Number	:	717-531-0882

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	08/16/2024

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