Individual
MR. BRADLEY M WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004685
GA
363A00000X
Physician Assistant
Primary
50.006426RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0410432
—
OH
Enumeration date
06/14/2006
Last updated
12/15/2023
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