Provider Demographics
NPI:1578544953
Name:WOLANSKI, EDWARD T (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:T
Last Name:WOLANSKI
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 1:600 PETER JEFFERSON PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8835
Mailing Address - Country:US
Mailing Address - Phone:434-293-9800
Mailing Address - Fax:434-977-0088
Practice Address - Street 1:600 PETER JEFFERSON PKWY STE 300
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8837
Practice Address - Country:US
Practice Address - Phone:434-293-9800
Practice Address - Fax:434-977-0088
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039930207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADG6598OtherMEDICARE RAILROAD GROUP
VADG6598OtherMEDICARE RAILROAD GROUP
B10401Medicare UPIN