Individual
DR. MARK WILLIAM WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 MAIN ST, HYANNIS, MA 02601-3129
(508) 778-1829
(508) 778-0113
Mailing address
25 MAIN ST, HYANNIS, MA 02601-3129
(508) 778-1829
(508) 778-0113
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
72524
MA
207RI0011X
Interventional Cardiology Physician
72524
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000030686
BOSTON MEDICAL CENTER
MA
01
—
060058507
MEDICARE ID
MA
01
—
072524
TUFTS
MA
01
—
11091976
CAQH
—
01
—
1962500322
UNICARE
MA
01
—
22772959
AETNA
MA
01
—
25-00639
UNITED HEALTHCARE
MA
01
—
300157
HARVARD PILGRIM
MA
01
—
3094730-001
CIGNA
MA
05
—
3155595
—
MA
01
—
J16944
BLUE CROSS BLUE SHIELD
MA
01
—
S017060
TRICARE
MA
Enumeration date
09/20/2006
Last updated
03/18/2009
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