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General NPI Number Information
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NPI Number | 1003981408
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Entity Type | Individual
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Provider Name | MICHAEL LEONARD OLIVIER M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 3790 CUMBERLAND LAKES DR
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City | MONTEREY
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State | TN
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Zip | 38574-7155
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Country | US
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Telephone | 931-200-4905
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Fax |
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Provider Business Mailing Address
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Address Line | 3790 CUMBERLAND LAKES DR
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City | MONTEREY
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State | TN
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Zip | 38574-7155
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Country | US
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Telephone | 605-255-4101
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Fax | 605-255-4687
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 5809
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 51982
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License Number State | TN
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