=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437171394
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHAEL P. OLEARY MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2006
-----------------------------------------------------
Last Update Date | 09/01/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 950 E HARVARD AVE SUITE 100
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80210-7009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-777-5147
-----------------------------------------------------
Fax | 303-996-1336
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 950 E HARVARD AVE SUITE 100
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80210-7009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-777-5147
-----------------------------------------------------
Fax | 303-996-1336
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MICHAEL P OLEARY
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 303-777-5147
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | 29406
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 29406
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------