Individual
DR. PAUL LOUIS WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
601 W US HIGHWAY 30, SCHERERVILLE, IN 46375-2656
(219) 322-0501
(219) 322-0577
Mailing address
601 W US HIGHWAY 30, SCHERERVILLE, IN 46375-2656
(219) 322-0501
(219) 322-0577
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
12010083A
IN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
12010083
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084422
BC BS PROVIDER PIN NUMBER
IN
05
—
200196800
—
IN
01
—
986521
UNITED CONCORDIA NUMBER
IN
01
—
P00111143
RAILROAD MEDICARE NUMBER
IN
Enumeration date
11/09/2005
Last updated
11/26/2019
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