Individual
DR. JASON SANFORD WOLFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9645 GROVE CIR N STE 200, MAPLE GROVE, MN 55369
(763) 201-8191
(763) 201-8192
Mailing address
9645 GROVE CIR N STE 200, MAPLE GROVE, MN 55369-4466
(763) 201-8191
(763) 201-8192
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
2004011783
MO
208VP0014X
Interventional Pain Medicine Physician
Primary
49469
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49469
MN LICENSE
MN
Enumeration date
05/14/2007
Last updated
06/13/2018
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