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NPI Code Detail

MEDICARE: DONALD WOLFRAM M.D.

MEDICARE: DONALD WOLFRAM 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
1207P00000XEmergency Medicine Physician01041640AIN
2207P00000XEmergency Medicine Physician4301082038MI
3207Q00000XFamily Medicine Physician4301082038MI

General Provider Information

NPI Number : 1669499257
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD WOLFRAM M.D.
Provider Business Mailing Address
First Line : 9625 RED ARROW HWY
Second Line :
City : BRIDGMAN
State : MI
Zip : 49106-9559
Country : US
Telephone Number : 269-465-6050
Fax Number : 269-465-3134
Provider Business Practice Location Address
First Line : 9625 RED ARROW HWY
Second Line :
City : BRIDGMAN
State : MI
Zip : 49106-9559
Country : US
Telephone Number : 269-465-6050
Fax Number : 269-465-3134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 03/17/2018

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Directions to “ DONALD WOLFRAM M.D.” Practice Location

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