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Individual

DR. MELINDA MARIE WOLTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
791 HARTFORD PIKE, DAYVILLE, CT 06241-1715
(860) 779-6123
(860) 779-8655
Mailing address
75 HOCKANUM BLVD, SUITE #933, VERNON, CT 06066-4056
(860) 871-2510
(860) 871-2510

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002646
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
026460
CONNECTICARE PROVIDER ID#
CT
01
090002646CT01
ANTHEM BCBS ID# DAYVILLE
01
090002646CT03
ANTHEM BCBS ID# ENFIELD
01
2559577
UNITEDHEALTHCARE
01
7164708
CIGNA PPO ID#
01
900733
EYEMED
01
P3641716
OXFORD
Enumeration date
11/30/2006
Last updated
07/08/2007
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