Individual
THOMAS A WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 W 23RD ST, STE A, FREMONT, NE 68025-2592
(402) 721-7077
(402) 753-6056
Mailing address
PO BOX 11724, BELFAST, ME 04915-4008
(402) 721-7077
(402) 753-6056
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23824
NE
208M00000X
Hospitalist Physician
0430314
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025238700
—
NE
01
—
31173
BCBS
NE
01
—
P00357706
RR MEDICARE
—
Enumeration date
07/10/2006
Last updated
07/17/2013
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