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MILTONIA M WOLUCHEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1331 MOUNT ZION RD, MORROW, GA 30260-2357
(770) 629-3217
(404) 666-0085
Mailing address
1331 MOUNT ZION RD, MORROW, GA 30260-2357
(770) 629-3217
(404) 666-0085

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
196867
NY
207R00000X
Internal Medicine Physician
Primary
76541
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0414039
IHA #
NY
01
051101000018
FIDELIS CARE #
NY
01
619687-6W
WORKERS COMP #
NY
01
9250
SIDNEY HILLMAN #
NY
01
MDH910
PREFERRED CARE #
NY
01
P010196867
BLUE CHOICE #
NY
Enumeration date
05/02/2006
Last updated
03/24/2025
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