Provider Demographics
NPI:1992798086
Name:PALOSKI, WILLIAM GEORGE (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GEORGE
Last Name:PALOSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 MARKET ST
Mailing Address - Street 2:P O BOX 2767
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44507-1821
Mailing Address - Country:US
Mailing Address - Phone:330-782-8071
Mailing Address - Fax:330-788-1096
Practice Address - Street 1:3100 MARKET ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44507-1821
Practice Address - Country:US
Practice Address - Phone:330-782-8071
Practice Address - Fax:330-788-1096
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:2006-03-27
Deactivation Code:
Reactivation Date:2006-04-12
Provider Licenses
StateLicense IDTaxonomies
OH34002293207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0303960Medicaid
OHE00620Medicare UPIN
OH0303960Medicaid