MEDICARE: SCOTT M OLIARO ATC

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	174400000X	Specialist	0219	NC
2	2255A2300X	Athletic Trainer	0219	NC
3	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1538173927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT M OLIARO ATC

Provider Business Mailing Address
First Line	:	812 LONG MEADOWS RD
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-4335
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	BELL TOWER LOT RD
Second Line	:	KENAN FOOTBALL CENTER
City	:	CHAPEL HILL
State	:	NC
Zip	:	27515-2126
Country	:	US
Telephone Number	:	919-962-8519
Fax Number	:

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	12/08/2021

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