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General NPI Number Information
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NPI Number | 1720957210
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Entity Type | Individual
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Provider Name | MR. MICHAEL ANDREW OLESNAVICH
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Gender | Male
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 1069 SMITH AVE
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City | BIRMINGHAM
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State | MI
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Zip | 48009-4706
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Country | US
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Telephone | 248-205-0748
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Fax | 248-737-1525
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Provider Business Mailing Address
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Address Line | 5725 SUTTERS LN
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48301-1059
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Country | US
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Telephone | 248-205-0748
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Fax | 248-737-1525
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State | MI
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