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NPI Code Detail

MEDICARE: MRS. OLGA SERDUKOVA NP

MEDICARE: MRS. OLGA SERDUKOVA NP
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
1363LF0000XFamily Nurse Practitioner4704236328MI

General Provider Information

NPI Number : 1578743886
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. OLGA SERDUKOVA NP
Provider Business Mailing Address
First Line : 6522 DONEGAN CT
Second Line :
City : BLOOMFIELD HILLS
State : MI
Zip : 48301-2811
Country : US
Telephone Number : 248-860-1287
Fax Number :
Provider Business Practice Location Address
First Line : 3010 WALTON BLVD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48309-1264
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2007
Last Update Date : 04/29/2025

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