Provider Demographics
NPI:1326550914
Name:DOLFIE, ANDREW JOHN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOHN
Last Name:DOLFIE
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 JEROME ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-5550
Mailing Address - Country:US
Mailing Address - Phone:615-715-9988
Mailing Address - Fax:
Practice Address - Street 1:3 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-2924
Practice Address - Country:US
Practice Address - Phone:641-754-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA090942363A00000X
TN4596363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant