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Individual

DR. MARCIA DEBRA WOLF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
19 WALKER AVE, SUITE 101, PIKESVILLE, MD 21208
(443) 213-8812
(443) 213-8813
Mailing address
4725 DORSEY HALL DR, SUITE A903, ELLICOTT CITY, MD 21042-7713
(443) 213-8812
(443) 213-8813

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
D035010
MD
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
D035010
MD
208VP0000X
Pain Medicine Physician
D035010
MD
208VP0014X
Interventional Pain Medicine Physician
D035010
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020046614
RAILROAD MEDICARE
01
0W64MD
CAREFIRST BC/BS
MD
05
200704500
MD
01
277R
OLD MC
MD
01
S1770001
BLUE SHEILD NATIONAL CAPI
DC
Enumeration date
09/21/2005
Last updated
07/11/2018
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