Provider Demographics
NPI:1205862737
Name:OLLENDORFF, ARTHUR T (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:T
Last Name:OLLENDORFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:213 S JEFFERSON ST STE 1006
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1713
Mailing Address - Country:US
Mailing Address - Phone:540-224-5715
Mailing Address - Fax:
Practice Address - Street 1:119 HENDERSONVILLE RD
Practice Address - Street 2:MAHEC OB/GYN SPECIALISTS
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2868
Practice Address - Country:US
Practice Address - Phone:828-771-5500
Practice Address - Fax:828-771-5454
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-1563207VG0400X, 207VX0000X
NC2010-01563207V00000X, 207V00000X
OH35-072731207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1205862737Medicaid
NC1205862737Medicaid
NC2076729Medicare PIN
OHOL0833024Medicare PIN
G58913Medicare UPIN