Provider Demographics
NPI:1477658060
Name:WOLF, RALPH ROBINSON (MD)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:ROBINSON
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 1:159 KINSLEY STREET
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3795
Mailing Address - Country:US
Mailing Address - Phone:603-889-1881
Mailing Address - Fax:603-889-1820
Practice Address - Street 1:159 KINSLEY STREET
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3795
Practice Address - Country:US
Practice Address - Phone:603-889-1881
Practice Address - Fax:603-889-1820
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5847207X00000X
MA79945207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C65810OtherHARVARD
NH703846OtherTUFTS
613OtherCIGNA
NH0106718Y0NH01OtherANTHEM
NH81206718Medicaid
10905890OtherAETNA
NHNH6718Medicare ID - Type Unspecified
NH0106718Y0NH01OtherANTHEM
613OtherCIGNA