Healthcare Provider Details

I. General information

NPI: 1508842600
Provider Name (Legal Business Name): PAUL J PAWLOSKY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1989 MIAMISBURG CENTERVILLE RD SUITE 302
CENTERVILLE OH
45459-3859
US

IV. Provider business mailing address

1989 MIAMISBURG CENTERVILLE RD SUITE 302
DAYTON OH
45459-3859
US

V. Phone/Fax

Practice location:
  • Phone: 937-528-6890
  • Fax: 937-528-6893
Mailing address:
  • Phone: 937-528-6890
  • Fax: 937-528-6893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34004550
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: