Individual
MARK K OLGAARD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
302 S MAIN ST, AU GRES, MI 48703-8700
(989) 876-7104
(989) 876-2881
Mailing address
PO BOX 779, TAWAS CITY, MI 48764-0779
(989) 362-0153
(989) 362-4683
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101008757
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3516709
—
MI
Enumeration date
10/06/2005
Last updated
07/08/2007
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