Provider Demographics
NPI:1932478492
Name:WOLFE, PAUL FREDERICK
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:FREDERICK
Last Name:WOLFE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 TUNNEL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1229
Mailing Address - Country:US
Mailing Address - Phone:828-255-4612
Mailing Address - Fax:828-255-4992
Practice Address - Street 1:29 TUNNEL RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-1229
Practice Address - Country:US
Practice Address - Phone:828-255-4612
Practice Address - Fax:828-255-4992
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21701183500000X
VA0202208098183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist