Provider Demographics
NPI:1033441548
Name:KLAHM, OLGA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:OLGA
Middle Name:
Last Name:KLAHM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:OLGA
Other - Middle Name:
Other - Last Name:PETROVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2799 WEST GRAND BLVD
Mailing Address - Street 2:K-12 ORTHOPAEDICS
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202
Mailing Address - Country:US
Mailing Address - Phone:313-916-2181
Mailing Address - Fax:313-916-2478
Practice Address - Street 1:2799 WEST GRAND BLVD
Practice Address - Street 2:K-12 ORTHOPAEDICS
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202
Practice Address - Country:US
Practice Address - Phone:313-916-2181
Practice Address - Fax:313-916-2478
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601005698363A00000X
FL9105160363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant