Individual
DR. MICHAEL CHARLES OLLENDIECK
Active
Individual
DR. MICHAEL CHARLES OLLENDIECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11457
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150461
—
MA
01
—
210491
TUFTS HEALTH PLAN
MA
01
—
J24080
BCBS MA
MA
Enumeration date
02/22/2006
Last updated
05/02/2019
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