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NPI Code Detail

MEDICARE: TERRENCE P WOLANSKI MD

MEDICARE: TERRENCE P WOLANSKI 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
1207RP1001XPulmonary Disease Physician26619NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
132882OTHERNCMEDCOST
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
388739OTHERNCBCBSNC

General Provider Information

NPI Number : 1740359082
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRENCE P WOLANSKI MD
Provider Business Mailing Address
First Line : PO BOX 12276
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-2276
Country : US
Telephone Number : 910-455-2124
Fax Number :
Provider Business Practice Location Address
First Line : 317 WESTERN BLVD
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-6379
Country : US
Telephone Number : 910-577-2345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 01/15/2010

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