Healthcare Provider Details

I. General information

NPI: 1437171394
Provider Name (Legal Business Name): MICHAEL P. OLEARY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 09/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 E HARVARD AVE SUITE 100
DENVER CO
80210-7009
US

IV. Provider business mailing address

950 E HARVARD AVE SUITE 100
DENVER CO
80210-7009
US

V. Phone/Fax

Practice location:
  • Phone: 303-777-5147
  • Fax: 303-996-1336
Mailing address:
  • Phone: 303-777-5147
  • Fax: 303-996-1336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number29406
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number29406
License Number StateCO

VIII. Authorized Official

Name: MICHAEL P OLEARY
Title or Position: OWNER
Credential: MD
Phone: 303-777-5147