Provider Demographics
NPI:1861602849
Name:WOLKOMIR, MICHAEL STERLING (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STERLING
Last Name:WOLKOMIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8139 LEE DR
Mailing Address - Street 2:
Mailing Address - City:BARNEVELD
Mailing Address - State:WI
Mailing Address - Zip Code:53507-9315
Mailing Address - Country:US
Mailing Address - Phone:608-924-1357
Mailing Address - Fax:608-924-3214
Practice Address - Street 1:201 S IOWA ST
Practice Address - Street 2:
Practice Address - City:DODGEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53533-1739
Practice Address - Country:US
Practice Address - Phone:608-930-2232
Practice Address - Fax:608-937-0024
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI20672208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice