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NPI Code Detail

MEDICARE: THEODORE OLENICK DO

MEDICARE: THEODORE OLENICK DO
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
1208000000XPediatrics Physician8871750ID

General Provider Information

NPI Number : 1396447025
Entity Type Code : Individual
Provider Name (Legal Business Name) : THEODORE OLENICK DO
Provider Business Mailing Address
First Line : 1 CHILDRENS PLZ
Second Line :
City : DAYTON
State : OH
Zip : 45404-1815
Country : US
Telephone Number : 937-641-3433
Fax Number : 937-641-5941
Provider Business Practice Location Address
First Line : 1 CHILDRENS PLZ
Second Line :
City : DAYTON
State : OH
Zip : 45404-1815
Country : US
Telephone Number : 937-641-3433
Fax Number : 937-641-5941
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2023
Last Update Date : 06/12/2026

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Directions to “ THEODORE OLENICK DO” Practice Location

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