Individual
MARK A WULFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3101 BROADWAY BLVD, KANSAS CITY, MO 64111-2659
(816) 960-3060
Mailing address
3101 BROADWAY BLVD, KANSAS CITY, MO 64111-2659
(816) 960-3060
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
105280
MO
208000000X
Pediatrics Physician
Primary
105280
MO
2080A0000X
Pediatric Adolescent Medicine Physician
105280
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207748617
—
MO
Enumeration date
06/05/2006
Last updated
10/14/2015
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