Provider Demographics
NPI:1437182862
Name:WOLOSZYN, DONALD R (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
Last Name:WOLOSZYN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:329 MAINE STREET
Mailing Address - Street 2:STE C
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011
Mailing Address - Country:US
Mailing Address - Phone:207-729-5720
Mailing Address - Fax:207-729-5691
Practice Address - Street 1:329 MAINE STREET
Practice Address - Street 2:STE C
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011
Practice Address - Country:US
Practice Address - Phone:207-729-5720
Practice Address - Fax:207-729-5691
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME017720207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432874699Medicaid
ME000497701Medicare PIN