MEDICARE: DR. CHRIS M OLENECH V DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	CO001358	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
10	480009053	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	107182	OTHER	MI	CARE CHOICES
2	4034087	OTHER	MI	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	480H219870	OTHER	MI	BLUE CARE NETWORK
5	QMXPR0036301	OTHER	MI	MOLINA
6	4858251630	OTHER	MI	BCBS
7	5825163	OTHER	MI	BCBS
8	C3706	OTHER	MI	M-CARE
9	1001793	OTHER	MI	CIGNA
11	5825163	OTHER	MI	BCN
12	U06128	OTHER	MI	HAP

General Provider Information

NPI Number	:	1225032196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRIS M OLENECH V DPM

Provider Business Mailing Address
First Line	:	3976 DIX HWY
Second Line	:
City	:	LINCOLN PARK
State	:	MI
Zip	:	48146-3940
Country	:	US
Telephone Number	:	313-386-5750
Fax Number	:	313-386-0579

Provider Business Practice Location Address
First Line	:	3976 DIX HWY
Second Line	:
City	:	LINCOLN PARK
State	:	MI
Zip	:	48146-3940
Country	:	US
Telephone Number	:	313-386-5750
Fax Number	:	313-386-0579

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	08/04/2011

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