Organization
MARK WOLF, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK D WOLF M.D. (OWNER/OPERATED)
(248) 830-6697
Entity
Organization
Contact information
Practice address
2055 BLOOMFIELD WOODS CT, WEST BLOOMFIELD, MI 48323-1915
(248) 335-0537
Mailing address
2055 BLOOMFIELD WOODS CT, WEST BLOOMFIELD, MI 48323-1915
(248) 335-0537
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
4301052955
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3521084
—
MI
01
—
4408234271
BCBS
—
Enumeration date
08/02/2010
Last updated
11/13/2015
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