Individual
MICHAEL J WOLOSCHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2670 SOUTH RACCOON STE 1, AUSTINTOWN, OH 44515-5344
(330) 799-3937
(330) 799-1557
Mailing address
2670 SOUTH RACCOON STE 1, AUSTINTOWN, OH 44515-5344
(330) 799-3937
(330) 799-1557
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3579T706
OH
152WC0802X
Corneal and Contact Management Optometrist
3579T706
OH
152WL0500X
Low Vision Rehabilitation Optometrist
3579T706
OH
152WP0200X
Pediatric Optometrist
3579T706
OH
152WV0400X
Vision Therapy Optometrist
3579T706
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000142252
ANTHEM
OH
05
—
0560576
—
OH
01
—
2200637
UHC MEDICARE COMPLETE
OH
01
—
341923934
UNISON
OH
01
—
341923934027
CARESOURCE
OH
01
—
410047096
RAILROAD MEDICARE
OH
Enumeration date
01/30/2007
Last updated
03/21/2008
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