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NPI Code Detail

MEDICARE: JOHN WOLFERT PA-C

MEDICARE: JOHN WOLFERT PA-C
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
1363A00000XPhysician AssistantPA4309MA
2207Q00000XFamily Medicine PhysicianPA4309MA

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 : 1902079494
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN WOLFERT PA-C
Provider Business Mailing Address
First Line : 145 ROSEMARY STREET
Second Line : SUITE C
City : NEEDHAM
State : MA
Zip : 02494-3259
Country : US
Telephone Number : 781-235-7900
Fax Number : 781-237-9930
Provider Business Practice Location Address
First Line : 145 ROSEMARY STREET
Second Line : SUITE C
City : NEEDHAM
State : MA
Zip : 02494-3259
Country : US
Telephone Number : 781-235-7900
Fax Number : 781-237-9930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2008
Last Update Date : 03/10/2026

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