Provider Demographics
NPI:1851352660
Name:WOLFE, JOANNE M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:M
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 1:12500 W 58TH AVE UNIT 233
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1104
Mailing Address - Country:US
Mailing Address - Phone:720-536-5282
Mailing Address - Fax:720-596-4364
Practice Address - Street 1:12500 W 58TH AVE UNIT 233
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1104
Practice Address - Country:US
Practice Address - Phone:720-536-5282
Practice Address - Fax:720-596-4364
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2023-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001013386208000000X
CODR.0063441208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODR.0063441OtherSTATE LICENSE
MO205700909Medicare ID - Type Unspecified
MO091010556Medicare ID - Type Unspecified