| NPI | 1801073499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW T WOLF Contract/Credentialing Manager 740-687-5164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35056043) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35059549) |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2012-10-09 |