Individual
MARY KATHERINE OLIVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 E MEDICAL CENTER DRIVE, 11TH FLOOR CS MOTT CHILDRENS HOSPITAL, ANN ARBOR, MI 48109-5204
(734) 764-5176
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301110418
MI
2080P0202X
Pediatric Cardiology Physician
Primary
4301110418
MI
2080P0203X
Pediatric Critical Care Medicine Physician
Q3935
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2009
Last updated
07/28/2016
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