| Doctor Name: | TODD WOLFORD |
| NPI Number: | 1033501937 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP-BC |
| License Number: | 71005415A |
| Business Practice Address: | 6301 University Commons Suite 100 South Bend, IN - 466351571 |
| Business Phone Number: | 5742474667 |
| Business Fax Number: | 5742714458 |
| Mailing Address: | 6301 University Commons, Suite 230 SOUTH BEND |
| State: | IN |
| Postal Code: | 466351571 |
| Phone Number: | 5742512100 |
| Fax Number: | 5742512150 |
| NPI Enumeration Date: | 03/02/2015 |
| NPI Last Update Date: | 04/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 71005415A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |