Individual
CONSTANCE L WOLDORFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1823
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89093K1
—
NC
01
—
NC5878B122
MEDICARE PTAN
NC
Enumeration date
11/21/2005
Last updated
03/07/2023
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