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NPI Code Detail

MEDICARE: MRS. MARGARET-ELIZABETH R WOLTER NP

MEDICARE: MRS. MARGARET-ELIZABETH R WOLTER NP
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
1363LF0000XFamily Nurse Practitioner4704212017MI

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 : 1447251442
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARGARET-ELIZABETH R WOLTER NP
Provider Business Mailing Address
First Line : PO BOX 776982
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6982
Country : US
Telephone Number : 231-672-2119
Fax Number : 313-432-7759
Provider Business Practice Location Address
First Line : 6401 PRAIRIE ST STE 2600
Second Line :
City : NORTON SHORES
State : MI
Zip : 49444-7842
Country : US
Telephone Number : 231-672-7900
Fax Number : 231-672-7931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 10/03/2024

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