Individual
KEISHA DALE WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20015
(202) 476-5000
Mailing address
711 DIAMOND AVE, ALEXANDRIA, VA 22301
(931) 261-6098
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0102203917
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/12/2013
Last updated
06/25/2023
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