Provider Demographics
NPI:1891831665
Name:WOLFE, THOMAS PHILLIP (MD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:PHILLIP
Last Name:WOLFE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6700 NORTH ROCHESTER RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306
Mailing Address - Country:US
Mailing Address - Phone:248-650-1534
Mailing Address - Fax:248-650-1537
Practice Address - Street 1:6700 NORTH ROCHESTER RD
Practice Address - Street 2:SUITE 112
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48306
Practice Address - Country:US
Practice Address - Phone:248-650-1534
Practice Address - Fax:248-650-1537
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MITW053571207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3133379Medicaid
F27398Medicare UPIN
MI3133379Medicaid