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Individual

DR. KEVIN JAY WOLF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
407 N. HERMAN ST, GOLDSBORO, NC 27530
(919) 583-9788
(919) 583-9790
Mailing address
407 N. HERMAN ST, GOLDSBORO, NC 27530
(919) 583-9788
(919) 583-9790

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
357
NC
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
357
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
357
NC
213ES0131X
Foot Surgery Podiatrist
357
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0818H
BCBS
NC
05
890818H
NC
Enumeration date
12/05/2006
Last updated
03/12/2014
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