Individual
TINA OLANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10950 W CAPITOL DR, WAUWATOSA, WI 53222-1110
(414) 464-4460
(414) 464-7074
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 464-4460
(414) 464-7074
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
41174
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32571200
—
WI
Enumeration date
08/21/2006
Last updated
06/11/2012
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