Provider Demographics
NPI:1679655260
Name:OLKEN, DAVID C (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:OLKEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WHITEHALL RD
Mailing Address - Street 2:HOSPITALIST SERVICE
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-3226
Mailing Address - Country:US
Mailing Address - Phone:603-330-7905
Mailing Address - Fax:
Practice Address - Street 1:11 WHITEHALL RD
Practice Address - Street 2:HOSPITALIST SERVICE
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3226
Practice Address - Country:US
Practice Address - Phone:603-330-7905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8512207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OLRE1710Medicare ID - Type Unspecified
E36858Medicare UPIN