MEDICARE: DR. MARTIN P KOLSKY M.D.

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	207W00000X	Ophthalmology Physician	MD5870	DC
2	207W00000X	Ophthalmology Physician	DOO17838	MD

General Provider Information

NPI Number	:	1083611883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN P KOLSKY M.D.

Provider Business Mailing Address
First Line	:	106 IRVING ST NW
Second Line	:	SUITE 321 SOUTH
City	:	WASHINGTON
State	:	DC
Zip	:	20010-2927
Country	:	US
Telephone Number	:	202-882-0200
Fax Number	:	202-291-4130

Provider Business Practice Location Address
First Line	:	106 IRVING ST NW
Second Line	:	SUITE 321
City	:	WASHINGTON
State	:	DC
Zip	:	20010-2927
Country	:	US
Telephone Number	:	202-882-0200
Fax Number	:	202-291-4130

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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