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Individual
DR. MARY VAN DEN BERG-WOLF
Active
Individual
DR. MARY VAN DEN BERG-WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD025054E
PA
207R00000X
Internal Medicine Physician
Primary
MD60806378
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014457420001
—
PA
Enumeration date
10/13/2005
Last updated
07/30/2018
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