Auguste C Wolle, PA-C
Physician Assistant in Saint Paul, MN. Individual provider (NPI-1).
NPI number1669984274
StatusActive
Last updated in NPPESSep 6, 2022
Details
- NPI
- 1669984274
- Entity type
- Individual (NPI-1)
- Name
- Mr. Auguste C Wolle
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 5, 2017
- Certification date
- Sep 6, 2022
- Last updated
- Sep 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 12978 | MN | Yes |
Practice location
401 Phalen BlvdSaint Paul, MN 55130-5302
Phone 651-254-7870 · Fax 651-254-7876
Mailing address
8170 33rd Ave SMs 21110q
Bloomington, MN 55425-4516
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