Individual
IVAN S. WOLFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 444-0468
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 444-0468
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD8535
RI
207QA0401X
Addiction Medicine (Family Medicine) Physician
MD8535
RI
Other
Enumeration date
12/05/2006
Last updated
04/26/2021
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