Individual
DR. BRADFORD J WOLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1674 W HIBISCUS BLVD, MELBOURNE, FL 32901-2631
(321) 473-7170
(321) 725-7780
Mailing address
1674 W HIBISCUS BLVD, MELBOURNE, FL 32901-2631
(321) 473-7170
(321) 725-7780
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
90227
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269824200
—
FL
01
—
44018
BLUE CROSS BLUE SHIELD
FL
01
—
ME 90227
ME
FL
Enumeration date
08/31/2005
Last updated
10/02/2012
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