| John Wesolowski, CRNA | |
|
289 Hickory Ridge Dr, Queenstown, MD 21658-1392 | |
| (410) 340-3705 | |
| (410) 827-7673 |
| Full Name | John Wesolowski |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 289 Hickory Ridge Dr, Queenstown, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962440255 | NPI | - | NPPES |
| NA96 | Other | MD | CARE FIRST BC/BS |
| K230 | Other | DC | CARE FIRST BC/BS |
| P00099944 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R078019 (Maryland) | Primary |
| Entity Name | North American Partners In Anesthesia Maryland Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093707879 PECOS PAC ID: 1850283144 Enrollment ID: O20040330000405 |
| Entity Name | Mukul Khandelwal, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316969256 PECOS PAC ID: 7416936620 Enrollment ID: O20040720000165 |
| Entity Name | Cumberland Anesthesia Ams Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033531785 PECOS PAC ID: 4981825056 Enrollment ID: O20141015001480 |
| Entity Name | Easton Anesthesia Associates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316491236 PECOS PAC ID: 5890076830 Enrollment ID: O20170105000279 |
| Mailing Address | Practice Location Address |
|---|---|
| John Wesolowski, CRNA Po Box 609, Laurel, MD 20725-0609 Ph: (410) 340-3705 | John Wesolowski, CRNA 289 Hickory Ridge Dr, Queenstown, MD 21658-1392 Ph: (410) 340-3705 |
Ms. Michelle Lee Moylan, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 305 Wye Harbor Dr, Queenstown, MD 21658 Phone: 410-703-1111 |