Doctor Name: | MAX OLESEVICH |
NPI Number: | 1073706677 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 52289-020 |
Business Practice Address: | 216 Sunset Pl Neillsville, WI - 544561706 |
Business Phone Number: | 7157433101 |
Business Fax Number: | |
Mailing Address: | 216 Sunset Pl, NEILLSVILLE |
State: | WI |
Postal Code: | 544561706 |
Phone Number: | 7157433101 |
Fax Number: | |
NPI Enumeration Date: | 08/27/2007 |
NPI Last Update Date: | 10/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 52289-020 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |