MEDICARE: CHAMION OLIVIER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	100766	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	28292	OTHER	SC	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1225110547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAMION OLIVIER MD

Provider Business Mailing Address
First Line	:	21 HOSPITAL DR STE 270
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-2454
Country	:	US
Telephone Number	:	386-344-1699
Fax Number	:	386-263-8880

Provider Business Practice Location Address
First Line	:	21 HOSPITAL DR STE 270
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-2454
Country	:	US
Telephone Number	:	386-344-1699
Fax Number	:	386-263-8880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	08/24/2023

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Directions to “ CHAMION OLIVIER MD” Practice Location

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