MEDICARE: CARLO A DALL'OLMO M.D.

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	2086S0129X	Vascular Surgery Physician	CD029682	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	382237803111	OTHER	MI	COMMUNITY CHOICE
2	B42956	OTHER	MI	HEALTH ALLIANCE PLAN
3	0615552	OTHER	MI	HEALTHPLUS OF MICHIGAN
4	105229	OTHER	MI	PREFERRED CHOICE PPO
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	105229	OTHER	MI	CARE CHOICE HMO
7	117047	OTHER	MI	GREAT LAKES HEALTH PLAN
8	204103	OTHER	MI	MCLAREN HEALTH PLAN/ADVAN
9	4294592	OTHER	MI	AETNA
10	C3723	OTHER	MI	M-CARE
11	0202515552	OTHER	ME	BC/BS OF MICHIGAN

General Provider Information

NPI Number	:	1235100926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLO A DALL'OLMO M.D.

Provider Business Mailing Address
First Line	:	5020 W BRISTOL RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507-2919
Country	:	US
Telephone Number	:	810-732-1620
Fax Number	:	810-732-8559

Provider Business Practice Location Address
First Line	:	5020 W BRISTOL RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507-2919
Country	:	US
Telephone Number	:	810-732-1620
Fax Number	:	810-732-8559

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

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	11/27/2007

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Directions to “ CARLO A DALL'OLMO M.D.” Practice Location

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