Doctor Name: | DOUGLAS R. WOLFE |
NPI Number: | 1124064837 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD12372 |
Business Practice Address: | 2715 Willetta St Sw Albany, OR - 973213471 |
Business Phone Number: | 5419265848 |
Business Fax Number: | 5419262873 |
Mailing Address: | 330 Nw Elks Dr, CORVALLIS |
State: | OR |
Postal Code: | 973303779 |
Phone Number: | 5417524622 |
Fax Number: | 5417542955 |
NPI Enumeration Date: | 06/21/2006 |
NPI Last Update Date: | 10/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD12372 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |