MEDICARE: CAROLINE WITT HAWES PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0010-08482	NC

General Provider Information

NPI Number	:	1376021972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE WITT HAWES PA-C

Provider Business Mailing Address
First Line	:	3201 S BRENTWOOD BLVD
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-1780
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 S BRENTWOOD BLVD
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-1780
Country	:	US
Telephone Number	:	314-912-4234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2018
Last Update Date	:	01/08/2026

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