Basic Information
Provider Information
NPI: 1053464412
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WOLFE
FirstName: PIERRE
MiddleName: P
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 EAST JEFFERSON STREET
Address2: KAISER PERMANENTE, PPQA, 6 WEST, ATTN: THERESA BROOKS
City: ROCKVILLE
State: MD
PostalCode: 20852
CountryCode: US
TelephoneNumber: 3018166660
FaxNumber: 3018166308
Practice Location
Address1: 12011 LEE-JACKSON MEMORIAL HIGHWAY
Address2: 2ND FLOOR
City: FAIRFAX
State: VA
PostalCode: 22033
CountryCode: US
TelephoneNumber: 7033835400
FaxNumber: 7033835547
Other Information
ProviderEnumerationDate: 01/19/2007
LastUpdateDate: 01/06/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200X0101025443VAN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RP1001X0101025443VAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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