Individual
ROY WAYNE WOLFRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2213 CHERRY ST, TOLEDO, OH 43608-2603
(419) 251-3232
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35075616
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000380633
IND BC/BS # ST. V-ER
OH
01
—
104818446
MICHIGAN MEDICAID
—
05
—
104824480
—
MI
05
—
2242675
—
OH
Enumeration date
04/11/2006
Last updated
06/11/2008
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