Provider Demographics
NPI:1114056090
Name:SANFORD M WOLFE DO
Entity type:Organization
Organization Name:SANFORD M WOLFE DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SINK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-223-4900
Mailing Address - Street 1:111 W 1ST ST STE 544
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1154
Mailing Address - Country:US
Mailing Address - Phone:937-223-4900
Mailing Address - Fax:937-223-4420
Practice Address - Street 1:111 W 1ST ST STE 544
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1154
Practice Address - Country:US
Practice Address - Phone:937-223-4900
Practice Address - Fax:937-223-4420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty