Provider Demographics
NPI:1396514931
Name:ADAM J OLSCAMP MD PC
Entity type:Organization
Organization Name:ADAM J OLSCAMP MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:W2 MANAGING EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:OLSCAMP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-457-4211
Mailing Address - Street 1:1233 N NORTHWOOD CENTER CT STE 101
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-6190
Mailing Address - Country:US
Mailing Address - Phone:208-457-4211
Mailing Address - Fax:208-773-1473
Practice Address - Street 1:8552 N GOVERNMENT WAY
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-9280
Practice Address - Country:US
Practice Address - Phone:208-457-4211
Practice Address - Fax:208-773-1473
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADAM J OLSCAMP MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-22
Last Update Date:2024-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty