Provider Demographics
NPI:1104173384
Name:WOLF, JOSHUA (MBBS)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:WOLF
Suffix:
Gender:M
Credentials:MBBS
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Mailing Address - Street 1:262 DANNY THOMAS PL
Mailing Address - Street 2:MAILSTOP 320
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-3678
Mailing Address - Country:US
Mailing Address - Phone:901-595-3486
Mailing Address - Fax:901-595-3099
Practice Address - Street 1:262 DANNY THOMAS PL
Practice Address - Street 2:MAILSTOP 320
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-3678
Practice Address - Country:US
Practice Address - Phone:901-595-3486
Practice Address - Fax:901-595-3099
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2014-01-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN506102080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases