Provider Demographics
NPI:1437199460
Name:WOLF, MELVYN ARNOLD (MD)
Entity Type:Individual
Prefix:DR
First Name:MELVYN
Middle Name:ARNOLD
Last Name:WOLF
Suffix:
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 1:585 MASON DR
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3109
Mailing Address - Country:US
Mailing Address - Phone:215-628-9726
Mailing Address - Fax:
Practice Address - Street 1:909 SUMNEYTOWN PIKE
Practice Address - Street 2:SUITE 201
Practice Address - City:SPRING HOUSE
Practice Address - State:PA
Practice Address - Zip Code:19477-1011
Practice Address - Country:US
Practice Address - Phone:215-542-1522
Practice Address - Fax:215-542-9609
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD010274E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4065240OtherAETNA
PA0045480000OtherKEYSTONE
PA1032352Medicaid
PA0045480000OtherKEYSTONE
PA1032352Medicaid