Provider Demographics
NPI:1417311762
Name:WOLFE, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:WOLFE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 QUEENS RD STE 400
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3264
Mailing Address - Country:US
Mailing Address - Phone:704-765-2578
Mailing Address - Fax:704-333-3397
Practice Address - Street 1:3781 MCDOWELL LN
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-8930
Practice Address - Country:US
Practice Address - Phone:843-390-8110
Practice Address - Fax:704-333-3397
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2025-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-140372085R0001X
MI390200000207QA0505X
SC958762085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine