Provider Demographics
NPI:1205416591
Name:OLEJNIK-BRZUSEK, SCARLETT ANNA (MD)
Entity type:Individual
Prefix:DR
First Name:SCARLETT
Middle Name:ANNA
Last Name:OLEJNIK-BRZUSEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SCARLETT
Other - Middle Name:
Other - Last Name:OLEJNIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:49167 WHITE MILL DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-1624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7138 S HIGHLAND DR STE 106
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-3775
Practice Address - Country:US
Practice Address - Phone:801-942-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-10
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
UT13928933-1205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program