MEDICARE: ANTOINETTE MICHELLE OLIVER AU.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	231H00000X	Audiologist	2201001847	VA
2	231H00000X	Audiologist	01452	MD

General Provider Information

NPI Number	:	1235622069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTOINETTE MICHELLE OLIVER AU.D.

Provider Business Mailing Address
First Line	:	918 PRINCE ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-3020
Country	:	US
Telephone Number	:	410-869-6625
Fax Number	:

Provider Business Practice Location Address
First Line	:	918 PRINCE ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-3020
Country	:	US
Telephone Number	:	571-775-3407
Fax Number	:

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

Provider Enumeration Date	:	06/06/2018
Last Update Date	:	10/21/2025

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