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Individual

DR. ROBERT J WOLF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1540 LAKE LANSING RD, SUITE 107, LANSING, MI 48912-3756
(517) 913-3800
(517) 913-3901
Mailing address
53 HUNTER RD, UXBRIDGE, MA 01569-1153
(508) 779-0357

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301073351
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0M21440051
MEDICARE ADVANTAGE
MI
01
1023349
MCLAREN HEALTH PLAN-COMMERCIAL
MI
01
200000001052
PHP
MI
01
255189
PHCS
01
3003314351
BLUE CROSS BLUE SHIELD OF MICHIGAN/BLUE CARE NETWORK
MI
05
4815847
MI
01
7721024
AETNA
01
P00350809
RAILROAD MEDICARE
Enumeration date
10/14/2005
Last updated
10/08/2009
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