Provider Demographics
NPI:1821022237
Name:WOLF, SONDRA K (MD)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:K
Last Name:WOLF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 IOTLA STREET
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-2506
Mailing Address - Country:US
Mailing Address - Phone:828-306-4407
Mailing Address - Fax:828-349-4424
Practice Address - Street 1:161 IOTLA STREET
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734
Practice Address - Country:US
Practice Address - Phone:828-306-4407
Practice Address - Fax:828-349-4424
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000670207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89126Y0Medicaid
NCH17640Medicare UPIN
NC2280656Medicare ID - Type Unspecified