Healthcare Provider Details

I. General information

NPI: 1396760021
Provider Name (Legal Business Name): MATTHEW J OLNES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 DIPLOMACY DR
ANCHORAGE AK
99508-5926
US

IV. Provider business mailing address

4315 DIPLOMACY DR
ANCHORAGE AK
99508-5926
US

V. Phone/Fax

Practice location:
  • Phone: 907-729-1500
  • Fax: 907-729-2082
Mailing address:
  • Phone: 907-729-1500
  • Fax: 907-729-2082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD-23115
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number3932
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number5841
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: