Provider Demographics
NPI:1003866781
Name:OLENCHOCK, STEPHEN ANTHONY JR (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ANTHONY
Last Name:OLENCHOCK
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:701 OSTRUM ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FOUNTAIN HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1155
Mailing Address - Country:US
Mailing Address - Phone:484-526-3890
Mailing Address - Fax:610-868-2915
Practice Address - Street 1:701 OSTRUM ST
Practice Address - Street 2:SUITE 201
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1155
Practice Address - Country:US
Practice Address - Phone:610-954-3890
Practice Address - Fax:610-868-2915
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2013-04-01
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Provider Licenses
StateLicense IDTaxonomies
MA2231282086S0102X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care