Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD044370L | PA |
Y | 207VX0201X | Gynecologic Oncologist | MD044370L | PA |
NPI | 1033173752 |
---|---|
Provider Name | George J Olt |
First Address | Lancaster, PA 17601-2644 |
Second Address | Lancaster, PA 17601-2644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 13/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012471650006 | (05) | PA |
C85838 | (02) |