Individual
MICHAEL D WOOLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
930 BETHESDA DR, ZANESVILLE, OH 43701-0815
(740) 450-7396
(740) 450-7469
Mailing address
860 BETHESDA DR, ZANESVILLE, OH 43701-1800
(740) 454-4651
(740) 454-4653
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3507518
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0989499
—
OH
01
—
CA0426
MEDICARE GROUP PTAN
—
01
—
WO4020807
MEDICARE TYPE, UNSPECIFIED
OH
Enumeration date
06/14/2005
Last updated
11/09/2009
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