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NPI Code Detail

MEDICARE: JOHN R OLENYN M.D.

MEDICARE: JOHN R OLENYN 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
1207X00000XOrthopaedic Surgery Physician4301047831MI

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 : 1639161755
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN R OLENYN M.D.
Provider Business Mailing Address
First Line : 3100 CROSS CREEK PKWY
Second Line : SUITE 200
City : AUBURN HILLS
State : MI
Zip : 48326-2774
Country : US
Telephone Number : 248-377-8000
Fax Number : 248-377-2929
Provider Business Practice Location Address
First Line : 3100 CROSS CREEK PKWY
Second Line : SUITE 200
City : AUBURN HILLS
State : MI
Zip : 48326-2774
Country : US
Telephone Number : 248-377-8000
Fax Number : 248-377-2929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 01/08/2020

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