Individual
TODD NOEL WOLFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
10176 W 400 N STE B, MICHIGAN CITY, IN 46360-9009
(219) 809-9839
(219) 809-9841
Mailing address
10176 W 400 N STE B, MICHIGAN CITY, IN 46360-9009
(219) 809-9839
(219) 809-9841
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
71005415A
IN
363LF0000X
Family Nurse Practitioner
71005415A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033501937
—
IN
Enumeration date
03/02/2015
Last updated
04/30/2019
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