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Organization

MICHAEL J WOLOSCHAK OD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL J WOLOSCHAK O.D. (OWNER)
(330) 799-3937
Entity
Organization

Contact information

Practice address
2670 S RACCOON RD, SUITE #1, YOUNGSTOWN, OH 44515-5380
(330) 799-3937
(330) 799-1557
Mailing address
2670 S RACCOON RD, SUITE #1, YOUNGSTOWN, OH 44515-5380
(330) 799-3937
(330) 799-1557

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000142252
ANTHEM
05
0560576
OH
01
118090
EYEMED
01
2200637
UNITED HEALTHCARE
01
289440488009
MEDICAL MUTUAL
01
410047096
RAILROAD MEDICARE
01
53992
UNISON
Enumeration date
11/21/2007
Last updated
04/23/2008
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