Provider Demographics
NPI:1316934003
Name:ROLITSKY, CHRIS D (MD)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:D
Last Name:ROLITSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20452
Mailing Address - Street 2:VPI/CYAD-CREDENTIALING
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-0452
Mailing Address - Country:US
Mailing Address - Phone:614-442-2406
Mailing Address - Fax:614-442-2410
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:PATHOLOGY DEPT - VPI
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-2978
Practice Address - Fax:937-208-6137
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35080222207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00636396OtherRR MCR
OH4131212OtherMEDICARE PIN LINKED TO VPI
OH2426753Medicaid
OH4131214Medicare PIN
RO4131212Medicare PIN