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NPI Code Detail

MEDICARE: JORDAN WOLF MD

MEDICARE: JORDAN WOLF MD
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
1390200000XStudent in an Organized Health Care Education/Training ProgramMI
2207L00000XAnesthesiology Physician8281509ID

General Provider Information

NPI Number : 1659000537
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN WOLF MD
Provider Business Mailing Address
First Line : 1500 E MEDICAL CENTER DR
Second Line :
City : ANN ARBOR
State : MI
Zip : 48109-5000
Country : US
Telephone Number : 734-936-4280
Fax Number :
Provider Business Practice Location Address
First Line : 1500 E MEDICAL CENTER DR
Second Line :
City : ANN ARBOR
State : MI
Zip : 48109-5000
Country : US
Telephone Number : 734-936-4280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2022
Last Update Date : 06/08/2026

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