Provider Demographics
NPI:1760643001
Name:OLDS, MICHAEL STANLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STANLEY
Last Name:OLDS
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 1:4201 31ST ST S APT 337
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2155
Mailing Address - Country:US
Mailing Address - Phone:202-812-1644
Mailing Address - Fax:703-888-2999
Practice Address - Street 1:4201 31ST ST S APT 337
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-2155
Practice Address - Country:US
Practice Address - Phone:202-812-1644
Practice Address - Fax:703-888-2999
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program