Individual
DR. BRIGITTE WOLF-SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
86 HARRIS DRIVE, KILMARNOCK, VA 22482
(804) 435-2651
Mailing address
PO BOX 2255, KILMARNOCK, VA 22482-2255
(804) 435-2651
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101235318
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010032296
—
VA
01
—
279595
ANTHEM BCBS
VA
01
—
P00064003
RR MEDICARE
VA
Enumeration date
06/20/2006
Last updated
12/23/2009
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