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Individual
MS. MARY E TOLLE
Active
Individual
MS. MARY E TOLLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
103323
NC
363A00000X
Physician Assistant
Primary
103323
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8101937
—
NC
01
—
P00938348
RR MEDICARE
NC
Enumeration date
12/21/2006
Last updated
02/20/2025
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