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General NPI Number Information
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NPI Number | 1013185750
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Entity Type | Organization
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Legal Business Name | M R OLDEN & ASSOCIATES LLC
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 701 SUPERIOR AVE SUITE O
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City | MUNSTER
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State | IN
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Zip | 46321-4037
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Country | US
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Telephone | 219-922-4220
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Fax | 219-922-4020
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Provider Business Mailing Address
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Address Line | PO BOX 631
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City | RICHTON PARK
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State | IL
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Zip | 60471-0631
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Country | US
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Telephone | 708-748-6775
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Fax | 708-748-6775
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MICHAEL R OLDEN
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Credential | D.O.
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Telephone | 708-748-6775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 02000380A
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License Number State | IN
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