Individual
SAMUEL F WOLFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
9905 45TH AVENUE NORTH, SUITE 110, PLYMOUTH, MN 55442-3315
(763) 595-8414
(763) 595-8438
Mailing address
9905 45TH AVENUE NORTH, SUITE 110, PLYMOUTH, MN 55442-3315
(763) 595-8414
(763) 595-8438
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1706
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0909390001
DMERC
MN
01
—
102877
UCARE MINNESOTA
MN
01
—
19467W0
BLUE CROSS BLUE SHIELD
MN
01
—
2200080
MEDICA PRIMARY
MN
01
—
2202766
MEDICA CHOICE
FM
01
—
23979
HEALTH PARTNERS
MN
01
—
2499537
METROPOLITAN HEALTH PLAN
MN
05
—
315023200
—
MN
01
—
410038901
RAILROAD MEDICARE
FM
Enumeration date
12/19/2006
Last updated
12/22/2016
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