MEDICARE: BRETT A WOHLER M.D.

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	207Q00000X	Family Medicine Physician	0101042682	VA

General Provider Information

NPI Number	:	1174525232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT A WOHLER M.D.

Provider Business Mailing Address
First Line	:	6160 FULLER CT
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22310-2540
Country	:	US
Telephone Number	:	703-922-5577
Fax Number	:	703-971-9834

Provider Business Practice Location Address
First Line	:	6160 FULLER CT
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22310-2540
Country	:	US
Telephone Number	:	703-922-5577
Fax Number	:	703-971-9834

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	11/05/2008

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