MEDICARE: IRENE LUCY ATIENO OLONDE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD475056	PA
2	207Q00000X	Family Medicine Physician	D0097971	MD

General Provider Information

NPI Number	:	1013401439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRENE LUCY ATIENO OLONDE MD

Provider Business Mailing Address
First Line	:	7923 HONEYGO BLVD
Second Line	:	217
City	:	NOTTINGHAM
State	:	MD
Zip	:	21236
Country	:	US
Telephone Number	:	443-470-2698
Fax Number	:	883-973-3543

Provider Business Practice Location Address
First Line	:	7923 HONEYGO BLVD
Second Line	:	217
City	:	NOTTINGHAM
State	:	MD
Zip	:	21236-9131
Country	:	US
Telephone Number	:	443-470-2698
Fax Number	:	883-973-3543

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2018
Last Update Date	:	01/21/2026

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