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NPI Code Detail

MEDICARE: RITA WOLF MD

MEDICARE: RITA 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
1207Q00000XFamily Medicine Physician44796MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710970090
Entity Type Code : Individual
Provider Name (Legal Business Name) : RITA WOLF MD
Provider Business Mailing Address
First Line : 111 HUNDERTMARK RD STE 115N
Second Line :
City : CHASKA
State : MN
Zip : 55318-1584
Country : US
Telephone Number : 952-442-2191
Fax Number :
Provider Business Practice Location Address
First Line : 111 HUNDERTMARK RD STE 115N
Second Line :
City : CHASKA
State : MN
Zip : 55318-1584
Country : US
Telephone Number : 952-442-2191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2005
Last Update Date : 11/14/2022

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