Organization Active NPI

Irving D. Wolfe, M.D.,PA

  • Dermatology Physician
  • Owings Mills, MD
National Provider Identifier
1386954790
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
IRVING D. WOLFE, M.D.,PA
Practice address
21 Crossroads Drive
#255
Owings Mills, MD 21117
Phone
(410) 363-2320
Fax
(410) 363-8475
NPI assigned
Oct 19, 2010
Last updated
Oct 19, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
IRVING D. WOLFE, MD, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Authorized official

Name
Irving D Wolfe, M.D.NPI 1508832346
Title
President
Phone
(410) 363-2320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

21 Crossroads Drive
#255
Owings Mills, MD 21117

Mailing address

21 Crossroads Drive
#255
Owings Mills, MD 21117
Phone (410) 363-2320

Other identifiers 1

IdentifierTypeStateIssuer
417511500MedicaidMD

National Provider Directory

National Provider Directory
Part of
Irving D Wolfe Mdpa

Locations

21 Crossroads Dr
Ste 255
Owings Mills, MD 21117
Phone (410) 363-2320

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1386954790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CROSSROADS DRIVE",
            "address_2": "#255",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "21117",
            "telephone_number": "410-363-2320",
            "fax_number": "410-363-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CROSSROADS DRIVE",
            "address_2": "#255",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "21117",
            "telephone_number": "410-363-2320",
            "fax_number": "410-363-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVING D. WOLFE, M.D.,PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IRVING D. WOLFE, MD, PA",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "IRVING",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-363-2320",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417511500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.