Provider Demographics
NPI:1265628093
Name:DEAN, JENNIFER ASHLEY WOLFF (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ASHLEY WOLFF
Last Name:DEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4374 NEW TOWN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2865
Mailing Address - Country:US
Mailing Address - Phone:757-259-1900
Mailing Address - Fax:757-259-1901
Practice Address - Street 1:4374 NEW TOWN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2865
Practice Address - Country:US
Practice Address - Phone:757-259-1900
Practice Address - Fax:757-259-1901
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101242864207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine