Provider Demographics
NPI:1194747105
Name:WOLFE, KEVIN W (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:W
Last Name:WOLFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:136 FURMAN RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5038
Mailing Address - Country:US
Mailing Address - Phone:828-268-1185
Mailing Address - Fax:828-265-8522
Practice Address - Street 1:136 FURMAN RD
Practice Address - Street 2:SUITE 6
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5038
Practice Address - Country:US
Practice Address - Phone:828-268-1185
Practice Address - Fax:828-265-8522
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2011-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2007-01896207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL048608600Medicaid
GA000488518BOtherMEDICAID OF GEORGIA
FL07168UOtherBCBS OF FLORIDA
FL4102501OtherAETNA
FL07168UOtherBCBS OF FLORIDA
FL4102501OtherAETNA
FLD61476Medicare UPIN