Provider Demographics
NPI:1447729678
Name:WOLFE, DAVID KENNETH II (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:KENNETH
Last Name:WOLFE
Suffix:II
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 S MAIN ST STE 11
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-7010
Mailing Address - Country:US
Mailing Address - Phone:518-573-0188
Mailing Address - Fax:
Practice Address - Street 1:442 S MAIN ST STE 11
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-7010
Practice Address - Country:US
Practice Address - Phone:518-573-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0389531183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist