Provider Demographics
NPI:1558345603
Name:WOLF, MICHAEL SAMUEL (PHARMD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SAMUEL
Last Name:WOLF
Suffix:
Gender:M
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 OLD YORK RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1924
Mailing Address - Country:US
Mailing Address - Phone:908-788-3635
Mailing Address - Fax:908-788-9472
Practice Address - Street 1:14 COMMERCE ST.
Practice Address - Street 2:WALD DRUGS
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822
Practice Address - Country:US
Practice Address - Phone:908-782-2224
Practice Address - Fax:908-806-6793
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01557700183500000X
PARP029223L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist