Individual
NORMAN TRACY WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1955 COUNTY ROAD B2 W, ROSEVILLE, MN 55113-2723
(651) 635-0054
(651) 635-0949
Mailing address
1955 COUNTY ROAD B2 W, ROSEVILLE, MN 55113-2723
(651) 635-0054
(651) 635-0949
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28650
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
514572400
—
MN
Enumeration date
02/15/2006
Last updated
12/28/2007
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