Wolfe, Shannon Micheal

Wolfe, Shannon Micheal is an individual health care provider with primary practice located at 1501 Maple Ave Nw Mob Suite 200, Richmond VA 23226-2553. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Wolfe, Shannon Micheal can be contacted via phone (804) 285-2300.

Contact Information

Primary practice address
1501 Maple Ave Nw Mob Suite 200 Richmond VA 23226-2553
Fax: (804) 285-8420
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0101223870 Virginia
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 0101223870 Virginia

Profile Details

NPI number 1275586463
LBN Legal business name Wolfe, Shannon Micheal
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Aug 14th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275586463 NPPES
Virginia MEDICAID 006401074
Virginia Other 173229

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