Individual
MRS. KATIE ANN WOLTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2901 CORPORATE PARK DR, OPELIKA, AL 36801-7283
(334) 203-1766
(334) 203-1784
Mailing address
2901 CORPORATE PARK DRIVE, OPELIKA, AL 36801-7283
(334) 203-1766
(334) 203-1784
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
32796
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164807
—
AL
01
—
511-52839
BLUE CROSS BLUE SHIELD OF AL
AL
Enumeration date
06/17/2010
Last updated
08/28/2019
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