Provider Demographics
NPI:1598176620
Name:WOLFE, JONATHAN DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DOUGLAS
Last Name:WOLFE
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 1:200 LOTHROP STREET
Mailing Address - Street 2:WING 5B
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2582
Mailing Address - Country:US
Mailing Address - Phone:412-647-6000
Mailing Address - Fax:412-647-2985
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2582
Practice Address - Country:US
Practice Address - Phone:412-647-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2023-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD481444207RC0200X, 207RI0011X
MO2017014151207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology