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NPI Code Detail

MEDICARE: OLIVIA MARIE HAN MD

MEDICARE:   OLIVIA MARIE HAN  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
12084P0802XAddiction Psychiatry Physician4351052003MI

General Provider Information

NPI Number : 1962188003
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA MARIE HAN MD
Provider Business Mailing Address
First Line : 4530 COLLINS RD APT 4224
Second Line :
City : LANSING
State : MI
Zip : 48910-8451
Country : US
Telephone Number : 906-367-2001
Fax Number :
Provider Business Practice Location Address
First Line : 4530 COLLINS RD APT 4224
Second Line :
City : LANSING
State : MI
Zip : 48910-8451
Country : US
Telephone Number : 906-367-2001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2023
Last Update Date : 06/23/2023

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