Kenneth Wolf, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

4301052877 Issued in MI

Practice address

1990 Union Lake Rd Ste 200
Commerce Township, MI 48382-2200

Phone

(248) 363-9413

NPI assigned

Feb 27, 2007

Last updated

Jan 10, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kenneth Wolf Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1083741367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 UNION LAKE RD STE 200",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483822200",
            "telephone_number": "248-363-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 UNION LAKE RD STE 200",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483822200",
            "telephone_number": "248-363-9413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MI",
            "license": "4301052877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNETH",
            "last_name": "WOLF",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Alegra Sylvia Christine Westphalen, LP
• William C. Easton D.C. P.C. (Airport Chiropractic Center)
• Jayme Robert Wilson, MA,CCC-SLP
• Richard Wlosinski, CRNA
• Amy O'Neill Woldring, R.PH
• Sara Wollenweber, SLP
• Robert Wayne Woodruff III, DO
• Woodward Detroit CVS LLC (CVS Pharmacy #16328)
• Woodward Detroit CVS, L.L.C. (CVS Pharmacy #08240)
• Cynthia Wright

• Plastic and Reconstructive Surgery Physician in Commerce Township, MI
• Providers in Commerce Township, MI by specialty
• Plastic and Reconstructive Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.