Individual
DR. MITCHEL L WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, 12TH FLOOR SUITE C, SAINT LOUIS, MO 63110-1032
(314) 362-3937
(314) 747-5375
Mailing address
660 S EUCLID AVE, C B 8096, SAINT LOUIS, MO 63110-1010
(314) 362-3937
(314) 747-5375
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
R5601
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0354668088
—
IL
05
—
201108826
—
MO
Enumeration date
07/17/2006
Last updated
07/16/2009
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