Individual
OLGA GENNADYEVNA DEWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 364-1000
Mailing address
1859 COBBLE CT, BRIGHTON, MI 48114-7658
(248) 252-5457
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301105687
MI
Other
Enumeration date
05/01/2014
Last updated
07/21/2022
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