MEDICARE: EWA OLECH 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	207RR0500X	Rheumatology Physician	14027	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225007032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EWA OLECH MD

Provider Business Mailing Address
First Line	:	8440 W LAKE MEAD BLVD
Second Line	:	STE 104
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-7648
Country	:	US
Telephone Number	:	702-489-4838
Fax Number	:	702-489-4837

Provider Business Practice Location Address
First Line	:	7200 CATHEDRAL ROCK DR STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0439
Country	:	US
Telephone Number	:	702-489-4838
Fax Number	:	702-489-4838

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

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	09/03/2019

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Directions to “ EWA OLECH MD” Practice Location

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