Provider Demographics
NPI:1306055033
Name:WOLMER, DONALD H (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:H
Last Name:WOLMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FOX HOLLOW
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656-2602
Mailing Address - Country:US
Mailing Address - Phone:201-391-0952
Mailing Address - Fax:
Practice Address - Street 1:10 FOX HOLLOW
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07656-2602
Practice Address - Country:US
Practice Address - Phone:201-391-9502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02028200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics