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NPI Code Detail

MEDICARE: JON OLETSKY M.D.

MEDICARE: JON OLETSKY 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
1207L00000XAnesthesiology PhysicianD0045664MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437159472
Entity Type Code : Individual
Provider Name (Legal Business Name) : JON OLETSKY M.D.
Provider Business Mailing Address
First Line : 301 HOSPITAL DR
Second Line :
City : GLEN BURNIE
State : MD
Zip : 21061-5803
Country : US
Telephone Number : 410-787-4000
Fax Number :
Provider Business Practice Location Address
First Line : 301 HOSPITAL DR
Second Line :
City : GLEN BURNIE
State : MD
Zip : 21061-5803
Country : US
Telephone Number : 410-787-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 09/16/2010

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