Provider Demographics
NPI:1356517551
Name:WOLSLEGEL, MAE JANN (DO)
Entity type:Individual
Prefix:DR
First Name:MAE
Middle Name:JANN
Last Name:WOLSLEGEL
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:344 THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-1509
Mailing Address - Country:US
Mailing Address - Phone:508-671-4050
Mailing Address - Fax:508-453-8050
Practice Address - Street 1:344 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-1509
Practice Address - Country:US
Practice Address - Phone:508-671-4050
Practice Address - Fax:508-453-8050
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2016-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA260848207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1356517551Medicare UPIN