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Contact Information

MATTHEW P WOLTER, CRNA
2300 N EDWARD ST
DECATUR, IL62526
 Phone: 217-876-8121
 Fax: 217-876-2261
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
Indicates primary specialty

NPI Profile & details for MATTHEW P WOLTER · (Male)

NPI Number 1376639062
Status Active
Credentials CRNA (Certified Registered Nurse Anesthetist)
Entity Individual
Enumeration date 10/04/2006
Last updated 03/01/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 209006102
Hospital affiliation(s)
  • DECATUR MEMORIAL HOSPITAL - (Acute Care)
    2300 NORTH EDWARD STREET
    DECATUR, IL 62526
  • ST JOHNS HOSPITAL - (Acute Care)
    800 E CARPENTER ST
    SPRINGFIELD, IL 62769
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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