MEDICARE: MATTHEW A OLEARCZYK 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	207Y00000X	Otolaryngology Physician	053010	GA

General Provider Information

NPI Number	:	1851396832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW A OLEARCZYK MD

Provider Business Mailing Address
First Line	:	3890 JOHNS CREEK PKWY
Second Line	:	STE 320
City	:	SUWANEE
State	:	GA
Zip	:	30024-1284
Country	:	US
Telephone Number	:	770-232-5253
Fax Number	:	770-232-5202

Provider Business Practice Location Address
First Line	:	3890 JOHNS CREEK PKWY
Second Line	:	STE 320
City	:	SUWANEE
State	:	GA
Zip	:	30024-1284
Country	:	US
Telephone Number	:	770-232-5253
Fax Number	:	770-232-5202

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	11/19/2007

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