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General NPI Number Information
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NPI Number | 1366594962
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Entity Type | Individual
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Provider Name | DIANA DEWOLFE P.A.
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1635 N. GEORGE MASON DRIVE SUITE 150
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City | ARLINGTON
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State | VA
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Zip | 22205
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Country | US
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Telephone | 301-663-6162
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Fax | 301-694-8525
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Provider Business Mailing Address
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Address Line | 1635 N GEORGE MASON DR STE 150
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City | ARLINGTON
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State | VA
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Zip | 22205-3679
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Country | US
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Telephone | 301-663-6162
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Fax | 301-694-8525
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110002675
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License Number State | VA
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