Healthcare Provider Details

I. General information

NPI: 1164734471
Provider Name (Legal Business Name): OLGA KARACHENETS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2010
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 EXCELSIOR BLVD
ST LOUIS PARK MN
55416-4728
US

IV. Provider business mailing address

4201 EXCELSIOR BLVD
MINNEAPOLIS MN
55416-4728
US

V. Phone/Fax

Practice location:
  • Phone: 952-933-8900
  • Fax: 952-945-9536
Mailing address:
  • Phone: 952-933-8900
  • Fax: 952-945-9536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number56075
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: