Provider Demographics
NPI:1518974427
Name:WOLOSHIN, STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:WOLOSHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N. MAIN STREET
Mailing Address - Street 2:VA OUTCOMES GROUP (111B)
Mailing Address - City:WHITE RIVER JCT
Mailing Address - State:VT
Mailing Address - Zip Code:05009
Mailing Address - Country:US
Mailing Address - Phone:802-296-5178
Mailing Address - Fax:
Practice Address - Street 1:215 N. MAIN STREET
Practice Address - Street 2:VA OUTCOMES GROUP (111B)
Practice Address - City:WHITE RIVER JCT
Practice Address - State:VT
Practice Address - Zip Code:05009
Practice Address - Country:US
Practice Address - Phone:802-296-5178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420009439207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine