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General NPI Number Information
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NPI Number | 1881699114
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Entity Type | Individual
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Provider Name | MICHAEL D WOOLERY MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 11/09/2009
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Provider Practice Location Address
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Address Line | 930 BETHESDA DR
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City | ZANESVILLE
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State | OH
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Zip | 43701-0815
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Country | US
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Telephone | 740-450-7396
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Fax | 740-450-7469
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Provider Business Mailing Address
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Address Line | 860 BETHESDA DR
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City | ZANESVILLE
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State | OH
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Zip | 43701-1800
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Country | US
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Telephone | 740-454-4651
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Fax | 740-454-4653
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 3507518
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License Number State | OH
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