Provider Demographics
NPI:1023832797
Name:WOLFE, DINA (RPH)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7379 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6358
Mailing Address - Country:US
Mailing Address - Phone:410-540-4483
Mailing Address - Fax:
Practice Address - Street 1:7379 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6358
Practice Address - Country:US
Practice Address - Phone:410-540-4483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist