Provider Demographics
NPI:1346365582
Name:WOLF, MELINDA JO (MD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:JO
Last Name:WOLF
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:14820 PHYSICIANS LANE
Mailing Address - Street 2:SUITE 241
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3951
Mailing Address - Country:US
Mailing Address - Phone:301-217-0333
Mailing Address - Fax:301-738-1976
Practice Address - Street 1:14820 PHYSICIANS LANE
Practice Address - Street 2:SUITE 241
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3951
Practice Address - Country:US
Practice Address - Phone:301-217-0333
Practice Address - Fax:301-738-1976
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD33129207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C62831Medicare UPIN