Individual
PAUL W KOLODZIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 MIRABEAU ST, GREENFIELD, OH 45123-1617
(937) 981-2216
(937) 981-9238
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35052684
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000315973
BCBS FOR UVMC
—
01
—
000000316737
BCBS
OH
01
—
000000329196
BLUE CROSS BLUE SHIELD
—
01
—
000000351194
ANTHEM BCBS/MARYSVILLE
OH
01
—
000000531260
ANTHEM
OH
01
—
000000537070
ANTHEM
OH
05
—
0608006
—
OH
05
—
201007380
—
KY
01
—
P00111883
RAILROAD MEDICARE
—
01
—
P00206144
RAIL ROAD MEDICARE
—
01
—
P00307842
RR MEDICARE FOR UVMC
—
01
—
P00441746
MEDICARE RAILROAD
OH
Enumeration date
06/07/2006
Last updated
03/30/2020
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