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NPI Code Detail

MEDICARE: DONALD GEORGE WOELTGE

MEDICARE:   DONALD GEORGE WOELTGE
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
1156FX1800XOptician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841324027
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD GEORGE WOELTGE
Provider Business Mailing Address
First Line : 2118 N MAPLE AVE
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-7813
Country : US
Telephone Number : 605-348-4778
Fax Number : 605-343-7275
Provider Business Practice Location Address
First Line : 2118 N MAPLE AVE
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-7813
Country : US
Telephone Number : 605-348-4778
Fax Number : 605-343-7275
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 07/08/2007

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Directions to “ DONALD GEORGE WOELTGE ” Practice Location

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