Individual
MICHAEL ALLEN OLYMPIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
397 HOLLINSWOOD AVE, WINSTON SALEM, NC 27103-6246
(336) 918-2132
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
27720
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
27720
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196460000
—
WV
01
—
5177086
AETNA
—
05
—
5740304
—
VA
01
—
6047
PARTNERS
NC
01
—
63973
MEDCOST
NC
01
—
64151
BCBS
NC
05
—
8964151
—
NC
05
—
Q27720
—
SC
Enumeration date
12/14/2005
Last updated
09/08/2017
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