Organization
WORCESTER UROLOGICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL R WOLLIN MD (PRESIDENT)
(508) 756-6293
Entity
Organization
Contact information
Practice address
25 OAK AVENUE, WORCESTER, MA 01605
(508) 756-6293
(508) 756-9404
Mailing address
25 OAK AVENUE, WORCESTER, MA 01605
(508) 756-6293
(508) 756-9404
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
—
MA
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81612175
—
MA
05
—
9701087
—
MA
Enumeration date
07/26/2005
Last updated
07/21/2022
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