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NPI Code Detail

MEDICARE: MS. DEANNA JO OLIVER PA-C

MEDICARE:  MS. DEANNA JO OLIVER  PA-C
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
1363AM0700XMedical Physician AssistantPA9104981FL
2363AM0700XMedical Physician AssistantPA031371DC

General Provider Information

NPI Number : 1295968451
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEANNA JO OLIVER PA-C
Provider Business Mailing Address
First Line : 4613 CHESTNUT ST
Second Line :
City : BETHESDA
State : MD
Zip : 20814-3723
Country : US
Telephone Number : 904-608-1090
Fax Number :
Provider Business Practice Location Address
First Line : 228 7TH ST SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20003-4306
Country : US
Telephone Number : 202-698-0795
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2009
Last Update Date : 12/07/2018

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Directions to “ MS. DEANNA JO OLIVER PA-C” Practice Location

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