Individual
OLIVIA LAUREN POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1800 MAPLE RD STE 100, WILLIAMSVILLE, NY 14221-2749
(716) 636-5437
Mailing address
1800 MAPLE RD STE 100, WILLIAMSVILLE, NY 14221-2749
(716) 636-5437
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
323941
NY
208000000X
Pediatrics Physician
OS13209
FL
208000000X
Pediatrics Physician
T7005
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014809000
—
FL
Enumeration date
04/03/2012
Last updated
09/06/2023
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