Provider Demographics
NPI:1649265653
Name:WOLFSON, ALLAN B (MD)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:B
Last Name:WOLFSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MCKEE PL
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3903
Mailing Address - Country:US
Mailing Address - Phone:412-647-8283
Mailing Address - Fax:412-647-8225
Practice Address - Street 1:1400 LOCUST ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5114
Practice Address - Country:US
Practice Address - Phone:412-232-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014597E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011228400002Medicaid
OH0991815Medicaid
WV0047970000Medicaid
PA0011228400011Medicaid
PA082878GX7Medicare PIN
PA0011228400011Medicaid
PA0011228400002Medicaid
PA082878HWUMedicare PIN
OH0991815Medicaid