MEDICARE: DR. DENNIS BRUCE KOLARIK D.O.

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	1978	OH

General Provider Information

NPI Number	:	1184867160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS BRUCE KOLARIK D.O.

Provider Business Mailing Address
First Line	:	7344 BARCLAY CT
Second Line	:
City	:	UNIVERSITY PARK
State	:	FL
Zip	:	34201-2340
Country	:	US
Telephone Number	:	941-351-2527
Fax Number	:

Provider Business Practice Location Address
First Line	:	2221 9TH ST SW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44706-1464
Country	:	US
Telephone Number	:	330-455-3663
Fax Number	:

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

Provider Enumeration Date	:	04/07/2009
Last Update Date	:	04/07/2009

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