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Organization

SHIBUMI, LLC

Active
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Organization

SHIBUMI, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RANDELL K WOLF MD (OWNER)
(513) 313-4060
Entity
Organization

Contact information

Practice address
310 STRAIGHT ST, CINCINNATI, OH 45219-1019
(513) 559-2777
Mailing address
908 WORTH ST, COVINGTON, KY 41011-2064
(513) 313-4060
(513) 558-5203

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
35051891
OH

Other

Enumeration date
11/28/2007
Last updated
11/28/2007
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