MEDICARE: HARVEY ALLEN OLDS 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	208000000X	Pediatrics Physician	28118	MI

General Provider Information

NPI Number	:	1255348595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARVEY ALLEN OLDS M.D.

Provider Business Mailing Address
First Line	:	2710 W COURT ST STE 10
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48503-3061
Country	:	US
Telephone Number	:	810-239-4679
Fax Number	:	810-239-8796

Provider Business Practice Location Address
First Line	:	2710 W COURT ST STE 10
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48503-3061
Country	:	US
Telephone Number	:	810-239-4679
Fax Number	:	810-239-8796

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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