Provider Demographics
NPI:1043505415
Name:WOLFE, STEPHANIE MANNING (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MANNING
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 N ELM ST STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-6312
Mailing Address - Country:US
Mailing Address - Phone:336-271-3331
Mailing Address - Fax:336-271-3724
Practice Address - Street 1:1103 N ELM ST STE 300
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6312
Practice Address - Country:US
Practice Address - Phone:336-271-3331
Practice Address - Fax:336-271-3724
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC174272390200000X
NC126122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program