Provider Demographics
NPI:1245225754
Name:OLSHEFSKI, RANDAL SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:RANDAL
Middle Name:SCOTT
Last Name:OLSHEFSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:614-722-3552
Mailing Address - Fax:614-722-3699
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2664
Practice Address - Country:US
Practice Address - Phone:614-722-3552
Practice Address - Fax:614-722-3699
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350585922080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2027194Medicaid
WV0111059000Medicaid
KY64956808Medicaid
WV0111059000Medicaid
OH010836521Medicare ID - Type Unspecified