Individual
DR. MICHAEL CHARLES OLLENDIECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 DOW JONES AVE, NASHUA, NH 03062-3089
(603) 889-3667
Mailing address
PO BOX 3677, NASHUA, NH 03061-3677
(603) 577-7900
(603) 577-7972
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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