Individual
DR. JONATHAN PAUL WULFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1501 KYLE STREET, EATON RAPIDS, MI 48827
(517) 663-4821
(517) 663-5650
Mailing address
PO BOX 269, EATON RAPIDS, MI 48827
(517) 663-4821
(517) 663-5650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
JW006732
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100445
PHYSICIAN HEALTH PLAN
MI
01
—
0152300115
BCBS
MI
05
—
1388397
—
MI
01
—
4053314
AETNA
MI
01
—
791063605
RR MEDICARE
MI
01
—
P59044
BLUE CHOICE POS
MI
Enumeration date
04/22/2006
Last updated
03/09/2016
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