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NPI Code Detail

MEDICARE: EDWARD H. WOLSKE M.D.

MEDICARE: EDWARD H. WOLSKE 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
1207P00000XEmergency Medicine Physician47593MN
2207Q00000XFamily Medicine Physician47593MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386629046
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD H. WOLSKE M.D.
Provider Business Mailing Address
First Line : 1551 290TH AVE
Second Line :
City : GARVIN
State : MN
Zip : 56132-1240
Country : US
Telephone Number : 507-828-9436
Fax Number :
Provider Business Practice Location Address
First Line : 2400 ST FRANCIS DR
Second Line :
City : BRECKENRIDGE
State : MN
Zip : 56520-1025
Country : US
Telephone Number : 218-643-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 04/01/2024

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Directions to “ EDWARD H. WOLSKE M.D.” Practice Location

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