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General NPI Number Information
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NPI Number | 1851000913
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Entity Type | Individual
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Provider Name | CLAIRE H WOLTER PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/17/2022
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 8120 GATEHOUSE RD FL 3
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1204
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Country | US
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Telephone | 703-573-3687
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Fax |
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Provider Business Mailing Address
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Address Line | 1207 RAYMOND AVE
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City | MC LEAN
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State | VA
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Zip | 22101-2633
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Country | US
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Telephone | 703-229-9279
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Fax |
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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 | 0110008933
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License Number State | VA
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