Individual
DR. RICHARD M. OLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
136 E BALTIMORE AVE, MEDIA, PA 19063-3428
(610) 565-3377
(610) 565-5351
Mailing address
136 E BALTIMORE AVE, MEDIA, PA 19063-3428
(610) 565-3377
(610) 565-5351
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
SC002111L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0032744000
BLUE SHIELD ID
PA
01
—
480000978
RAILROAD MEDICARE
PA
Enumeration date
01/19/2006
Last updated
10/28/2008
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