Provider Demographics
NPI:1972864403
Name:WURTZEL, CAROLINE NICOLE WOLFE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:NICOLE WOLFE
Last Name:WURTZEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14650 E OLD US HIGHWAY 12 STE 302
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14650 E OLD US HIGHWAY 12 STE 302
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1805
Practice Address - Country:US
Practice Address - Phone:855-450-2020
Practice Address - Fax:586-261-5231
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43011008962086S0105X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E06376OtherMEDICARE
MI700E063760OtherBCBS