Provider Demographics
NPI:1780693242
Name:SOLTES, DOLORES E (PA-C)
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:E
Last Name:SOLTES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-1964
Mailing Address - Country:US
Mailing Address - Phone:724-774-0232
Mailing Address - Fax:724-774-2696
Practice Address - Street 1:701 5TH ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-1964
Practice Address - Country:US
Practice Address - Phone:724-774-0232
Practice Address - Fax:724-774-2696
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002616L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S62199Medicare UPIN