Provider Demographics
NPI:1538278593
Name:OLARTE, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:OLARTE
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:5530 MUNFORD RD
Mailing Address - Street 2:SUITE 119
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-2638
Mailing Address - Country:US
Mailing Address - Phone:919-782-9554
Mailing Address - Fax:919-782-9130
Practice Address - Street 1:5530 MUNFORD RD
Practice Address - Street 2:SUITE 119
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-2638
Practice Address - Country:US
Practice Address - Phone:919-782-9554
Practice Address - Fax:919-782-9130
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2005016392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5903279Medicaid
NC5903279Medicaid