Provider Demographics
NPI:1881820249
Name:CRONIN, OLIVIA HELITHA (MD)
Entity Type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:HELITHA
Last Name:CRONIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:HELITHA
Other - Last Name:KENOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5256 E 65TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4819
Mailing Address - Country:US
Mailing Address - Phone:317-429-0120
Mailing Address - Fax:
Practice Address - Street 1:5256 E 65TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4819
Practice Address - Country:US
Practice Address - Phone:317-429-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2015-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01069418A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine