Individual
BRUCE WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3220 DISCOVERY DR STE 100, LANSING, MI 48910-7015
(517) 975-8930
(517) 337-4985
Mailing address
804 SERVICE RD STE A109B, EAST LANSING, MI 48824-7015
(517) 975-8930
(517) 337-4985
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
5101012460
MI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
5101012460
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275639874
—
MI
Enumeration date
09/15/2006
Last updated
07/06/2023
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