Individual
DR. DAWN MICHELLE WOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
12813 BERESFORD DR, STERLING HEIGHTS, MI 48313-4113
(586) 254-0421
Mailing address
12813 BERESFORD DR, STERLING HEIGHTS, MI 48313-4113
(586) 254-0421
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003859
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90-0-E0-6652-0
BCBS PROVIDER NUMBER
MI
01
—
MI2084
PTAN
MI
Enumeration date
06/13/2007
Last updated
10/04/2011
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