MEDICARE: STEVEN T WOOLSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	C39802	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MMM00087M	OTHER		NHIC

General Provider Information

NPI Number	:	1245295781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN T WOOLSON MD

Provider Business Mailing Address
First Line	:	PO BOX 60000
Second Line	:	FILE NUMBER 72484
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94160-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 BROADWAY ST
Second Line	:	MAILCODE 6342
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-3132
Country	:	US
Telephone Number	:	650-575-5417
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	07/25/2011

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