Provider Demographics
NPI:1083027346
Name:WASYLIK, DUSTIN JEFFREY (DO)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:JEFFREY
Last Name:WASYLIK
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-6355
Mailing Address - Country:US
Mailing Address - Phone:419-357-3359
Mailing Address - Fax:
Practice Address - Street 1:5655 MONCLOVA RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1870
Practice Address - Country:US
Practice Address - Phone:419-357-3359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293780207W00000X
WI81143207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology