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NPI Code Detail

MEDICARE: COREY A WULF M.D.

MEDICARE: COREY A WULF 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
1207X00000XOrthopaedic Surgery Physician46907MN
2207X00000XOrthopaedic Surgery Physician7582SD
3207X00000XOrthopaedic Surgery Physician38587IA
4207X00000XOrthopaedic Surgery Physician25360NE
5207XX0005XSports Medicine (Orthopaedic Surgery) Physician46907MN

General Provider Information

NPI Number : 1811968365
Entity Type Code : Individual
Provider Name (Legal Business Name) : COREY A WULF M.D.
Provider Business Mailing Address
First Line : 4200 DAHLBERG DR
Second Line : SUITE 300
City : GOLDEN VALLEY
State : MN
Zip : 55422-4840
Country : US
Telephone Number : 952-512-5600
Fax Number : 952-512-5651
Provider Business Practice Location Address
First Line : 4010 W 65TH ST
Second Line :
City : EDINA
State : MN
Zip : 55435-1706
Country : US
Telephone Number : 952-456-7000
Fax Number : 952-456-7001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 08/16/2024

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