MEDICARE: DR. GEORGIA K OLYMPIO 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	207ZC0500X	Cytopathology Physician	27719	NC
2	207ZD0900X	Dermatopathology (Pathology) Physician	27719	NC
3	207ZF0201X	Forensic Pathology Physician	27719	NC
4	207ZH0000X	Hematology (Pathology) Physician	27719	NC
5	207ZI0100X	Immunopathology Physician	27719	NC
6	207ZB0001X	Blood Banking & Transfusion Medicine Physician	27719	NC
7	207ZM0300X	Medical Microbiology Physician	27719	NC
8	207ZN0500X	Neuropathology Physician	27719	NC
9	207ZP0007X	Molecular Genetic Pathology (Pathology) Physician	27719	NC
10	207ZP0101X	Anatomic Pathology Physician	27719	NC
11	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	27719	NC
12	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	27719	NC
13	207ZP0104X	Chemical Pathology Physician	27719	NC
14	207ZP0213X	Pediatric Pathology Physician	27719	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	220048418	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	64053	OTHER	NC	BCBS OF NORTH CAROLINA

General Provider Information

NPI Number	:	1619945649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGIA K OLYMPIO M.D.

Provider Business Mailing Address
First Line	:	1899 TATE BLVD SE
Second Line	:	SUITE 1105
City	:	HICKORY
State	:	NC
Zip	:	28602-4200
Country	:	US
Telephone Number	:	828-322-3821
Fax Number	:	828-322-6697

Provider Business Practice Location Address
First Line	:	1899 TATE BLVD SE
Second Line	:	SUITE 1105
City	:	HICKORY
State	:	NC
Zip	:	28602-4200
Country	:	US
Telephone Number	:	828-322-3821
Fax Number	:	828-322-6697

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	07/30/2010

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