Individual
KATHLEEN MARY KOLASKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-8018
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-8018
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
009500121
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10515
PARTNERS
NC
01
—
132R6
BCBS
NC
05
—
218297000
—
WV
01
—
4590009
AETNA
NC
05
—
6803199
—
VA
05
—
89132R6
—
NC
01
—
B9682
MEDCOST
NC
Enumeration date
12/19/2005
Last updated
11/15/2010
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