Provider Demographics
NPI:1508842600
Name:PAWLOSKY, PAUL J (DO)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:PAWLOSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1989 MIAMISBURG CENTERVILLE RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-3859
Mailing Address - Country:US
Mailing Address - Phone:937-528-6890
Mailing Address - Fax:937-528-6893
Practice Address - Street 1:1989 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:SUITE 302
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-3859
Practice Address - Country:US
Practice Address - Phone:937-528-6890
Practice Address - Fax:937-528-6893
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004550207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000383921OtherUNICARE
OHD0455019OtherHUMANA/CHOICECARE
OH0720048OtherUNITED HEALTH CARE
OH0875414Medicaid
OH421534506071OtherCARESOURCE
OH2924729OtherAETNA
OH160058959OtherRAILROAD MEDICARE
OHD0455018OtherHUMANA/CHOICECARE
OH000000383921OtherANTHEM
OHPH00019044OtherNATIONWIDE HEALTH PLAN
OHPH00019044OtherNATIONWIDE HEALTH PLAN
OHF25823Medicare UPIN
OH000000383921OtherUNICARE