Provider Demographics
NPI:1346405511
Name:DEWOLF, WILLIAM F II (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:DEWOLF
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-9116
Mailing Address - Country:US
Mailing Address - Phone:941-363-0878
Mailing Address - Fax:941-460-5599
Practice Address - Street 1:801 OAK ST
Practice Address - Street 2:
Practice Address - City:GREEN COVE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32043-4317
Practice Address - Country:US
Practice Address - Phone:412-330-4000
Practice Address - Fax:412-330-4366
Is Sole Proprietor?:No
Enumeration Date:2008-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1396952084P0800X
PAMT1839712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA002110142OtherHIGHMARK BLUE SHIELD
PA161729OtherMEDICARE
PA0102366252000Medicaid