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NPI Code Detail

MEDICARE: ROBERT A OLSHAKER MD

MEDICARE: ROBERT A OLSHAKER MD
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
12085R0202XDiagnostic Radiology Physician0101048237VA
22085R0204XVascular & Interventional Radiology Physician0101048237VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00212165OTHERDCRAILROAD MEDICARE

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 : 1629068143
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT A OLSHAKER MD
Provider Business Mailing Address
First Line : 5655 HUDSON DR STE 210
Second Line : ARIS RADIOLOGY
City : HUDSON
State : OH
Zip : 44236-4455
Country : US
Telephone Number : 330-655-1869
Fax Number : 330-688-3828
Provider Business Practice Location Address
First Line : 2300 OPITZ BLVD
Second Line :
City : WOODBRIDGE
State : VA
Zip : 22191-3311
Country : US
Telephone Number : 703-670-1561
Fax Number : 703-670-4961
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2005
Last Update Date : 11/10/2016

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Directions to “ ROBERT A OLSHAKER MD” Practice Location

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