Individual
JEREMY DEWOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
645 AMALIA ST NE, CONCORD, NC 28025-2434
(704) 295-3255
(704) 295-7791
Mailing address
645 AMALIA ST NE, CONCORD, NC 28025-2434
(704) 295-3255
(704) 295-7791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06156
—
Other
Enumeration date
01/06/2016
Last updated
03/30/2021
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