Individual
MICHAEL R WOLLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Primary
70704
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20211512
—
MA
05
—
3045111
—
MA
Enumeration date
07/29/2005
Last updated
03/31/2010
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