Individual
NOALL E WOLFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
360 N 2ND ST, MONTPELIER, ID 83254-1208
(208) 847-5834
Mailing address
360 N 2ND ST, MONTPELIER, ID 83254-1208
(208) 847-5834
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M3559
ID
207Q00000X
Family Medicine Physician
Primary
M3599
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002462200
—
ID
01
—
756083066
MEDICARE RAILROAD
ID
Enumeration date
10/19/2006
Last updated
12/02/2016
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