Provider Demographics
NPI:1407943871
Name:OLSOWKA, EUGENE STANLEY (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:STANLEY
Last Name:OLSOWKA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9460 S SAGINAW RD STE D
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8207
Mailing Address - Country:US
Mailing Address - Phone:810-733-7741
Mailing Address - Fax:810-733-8898
Practice Address - Street 1:9460 S SAGINAW RD STE D
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8207
Practice Address - Country:US
Practice Address - Phone:810-733-7741
Practice Address - Fax:810-733-8898
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301063271207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1407943871Medicaid
MI4116480Medicaid
E89557Medicare UPIN