Individual provider Active NPI

Robert Edward Wolf, MD

  • Plastic Surgery Physician
  • Camp Hill, PA
National Provider Identifier
1619901303
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
044345L Issued in PA
Practice address
1857 Center St
Camp Hill, PA 17011-1773
Phone
(717) 763-7333
Fax
(717) 763-7330
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 044345L PA Primary

Addresses

Primary practice location

1857 Center St
Camp Hill, PA 17011-1773

Mailing address

1857 Center Street
Camp Hill, PA 17011-1738
Phone (717) 763-7333

Other identifiers 1

IdentifierTypeStateIssuer
001421802004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
044345LPAMDPlastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1619901303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1857 CENTER STREET",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170111738",
            "telephone_number": "717-763-7333",
            "fax_number": "717-763-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1857 CENTER ST",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170111773",
            "telephone_number": "717-763-7333",
            "fax_number": "717-763-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "044345L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001421802004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

  • 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.