Provider Demographics
NPI:1316262124
Name:WOLF, WILLIAM B III (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:WOLF
Suffix:III
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 1:117 W BOSCAWEN ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4158
Mailing Address - Country:US
Mailing Address - Phone:540-450-0334
Mailing Address - Fax:
Practice Address - Street 1:21257 FOXCROFT RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:VA
Practice Address - Zip Code:20117-3425
Practice Address - Country:US
Practice Address - Phone:301-529-9653
Practice Address - Fax:571-206-8954
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD30363174400000X
VA0101041005207XX0005X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No174400000XOther Service ProvidersSpecialist
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine