MEDICARE: DR. SCARLETT ANNA OLEJNIK-BRZUSEK 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	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	13928933-1205	UT

General Provider Information

NPI Number	:	1205416591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCARLETT ANNA OLEJNIK-BRZUSEK MD

Provider Business Mailing Address
First Line	:	49167 WHITE MILL DR
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48317-1624
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7138 S HIGHLAND DR STE 106
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-3775
Country	:	US
Telephone Number	:	801-942-1800
Fax Number	:

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

Provider Enumeration Date	:	04/10/2021
Last Update Date	:	05/29/2024

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