Provider Demographics
NPI:1922361989
Name:DOLGIKH, OLGA B (PA-C)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:B
Last Name:DOLGIKH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:29829 TELEGRAPH RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1330
Mailing Address - Country:US
Mailing Address - Phone:248-304-0786
Mailing Address - Fax:248-354-8559
Practice Address - Street 1:29829 TELEGRAPH RD
Practice Address - Street 2:SUITE 107
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1330
Practice Address - Country:US
Practice Address - Phone:248-304-0786
Practice Address - Fax:248-354-8559
Is Sole Proprietor?:No
Enumeration Date:2012-06-24
Last Update Date:2020-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601006378363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant