Norman Martin Wolk, M.D.
Individual provider Active NPI General Practice Physician · Hallock, MN
NPI 1467657114 · NPPES record last updated Jun 5, 2019
Key facts
- NPI
- 1467657114
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 4711 (MT)
- Practice address
- 1010 S Birch Ave
Hallock, MN 56728-4215 - Phone
- (218) 843-3612
- NPI assigned
- Jun 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25391 | MN | MD | Family Medicine Physician |
| 4711 | MT | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Montana Medical Facilities, Inc | Past | Accepting new patients | |
| Central Montana Medical Facilities, Inc. | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25391 | MN | |
| General Practice Physician | 208D00000X | 4711 | MT | Yes |
Addresses
Primary practice location
1010 S Birch Ave
Hallock, MN 56728-4215
Mailing address
855 Louisiana Ave
Brooklyn, NY 11239-2712
Phone (718) 642-7953
Other providers in Hallock, MN
All providers in Hallock, MN · General Practice Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.