Provider Demographics
NPI:1013980556
Name:WOLF, STEVEN D (DO)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:WOLF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2301 N OCOEE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-3863
Mailing Address - Country:US
Mailing Address - Phone:423-339-1400
Mailing Address - Fax:423-339-9950
Practice Address - Street 1:2301 N OCOEE ST
Practice Address - Street 2:SUITE A
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3863
Practice Address - Country:US
Practice Address - Phone:423-339-1400
Practice Address - Fax:423-339-9951
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2011-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN1531207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3814231Medicaid
TN3814231Medicaid
TNA16464Medicare UPIN