Provider Demographics
NPI:1780610279
Name:STOLARSKI, RAYMOND (DPM)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:STOLARSKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 WESLEY AVE
Mailing Address - Street 2:STE N
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2298
Mailing Address - Country:US
Mailing Address - Phone:513-841-5520
Mailing Address - Fax:513-841-1580
Practice Address - Street 1:8245 NORTHCREEK DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2283
Practice Address - Country:US
Practice Address - Phone:513-745-4706
Practice Address - Fax:513-891-1794
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002621213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0867727Medicaid
OHU20989Medicare UPIN
OH0867727Medicaid