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Individual

MICHAEL POOLE WOLF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
516 EAST NIZHONI BLVD., GALLUP, NM 87301-1337
(505) 722-1000
(505) 726-8557
Mailing address
P.O. BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 726-8557

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
228587
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02472897
NY
Enumeration date
08/04/2005
Last updated
03/08/2011
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