Provider Demographics
NPI:1972567279
Name:WOLZ, DEAN ERIC (MD)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:ERIC
Last Name:WOLZ
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 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-1200
Mailing Address - Country:US
Mailing Address - Phone:304-598-4000
Mailing Address - Fax:
Practice Address - Street 1:2001 EHRMAN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066
Practice Address - Country:US
Practice Address - Phone:724-631-0151
Practice Address - Fax:724-631-0227
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV27889207RC0000X
PAMD042814L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA764267OtherHIGHMARK PROVIDER NUMBER
PA764267OtherHIGHMARK PROVIDER NUMBER
764267Medicare PIN