Individual
JOHN J WOLF III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
25651 DETROIT RD, SUITE 304, WESTLAKE, OH 44145-2415
(440) 808-8620
(440) 899-4372
Mailing address
25651 DETROIT RD, SUITE 304, WESTLAKE, OH 44145-2415
(440) 808-8620
(440) 899-4372
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34 00 4794
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0746385
—
OH
01
—
110069035
RR MEDICARE
OH
Enumeration date
08/16/2005
Last updated
11/11/2020
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