Basic Information
| Provider Information | |||||||||
| NPI: | 1699717058 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OLEHNIK | ||||||||
| FirstName: | W | ||||||||
| MiddleName: | KEVIN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 GLEN COVE DR | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | ROCKPORT | ||||||||
| State: | ME | ||||||||
| PostalCode: | 048564235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2075935454 | ||||||||
| FaxNumber: | 2075935353 | ||||||||
| Practice Location | |||||||||
| Address1: | 4 GLEN COVE DR | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | ROCKPORT | ||||||||
| State: | ME | ||||||||
| PostalCode: | 048564235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2075935454 | ||||||||
| FaxNumber: | 2075935353 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2006 | ||||||||
| LastUpdateDate: | 07/06/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 013455 | ME | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0106X | 013455 | ME | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
No ID Information.