Provider Demographics
NPI:1821033366
Name:WOLFE, JUDITH ANN (MD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:WOLFE
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 1:19449 FRAZIER DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-1759
Mailing Address - Country:US
Mailing Address - Phone:216-513-2904
Mailing Address - Fax:
Practice Address - Street 1:1 AKRON GENERAL AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2432
Practice Address - Country:US
Practice Address - Phone:330-344-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222092207P00000X
OH88859207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
7782487OtherAETNA
NY222092-9WOtherWORKER'S COMPENSATION
4798987OtherGROUP HEALTH INCORP
NY02409236Medicaid
NY222092-9WOtherWORKER'S COMPENSATION