Individual
JOHN WESOLOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
289 HICKORY RIDGE DR, QUEENSTOWN, MD 21658-1392
(410) 340-3705
(410) 827-7673
Mailing address
PO BOX 609, LAUREL, MD 20725-0609
(410) 340-3705
(410) 827-7673
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R078019
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K230
CARE FIRST BC/BS
DC
01
—
NA96
CARE FIRST BC/BS
MD
01
—
P00099944
RAILROAD MEDICARE
—
Enumeration date
06/02/2006
Last updated
06/23/2008
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