Olivas, Jonathan Charles

Olivas, Jonathan Charles is an individual health care provider with primary practice located at 1301 8Th St S , Moorhead MN 56560-3604. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Olivas, Jonathan Charles can be contacted via phone (701) 234-3100.

Contact Information

Primary practice address
1301 8Th St S Moorhead MN 56560-3604
Phone: (701) 234-3100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 13439 North Dakota
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 58826 Minnesota

Profile Details

NPI number 1942599048
LBN Legal business name Olivas, Jonathan Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2011
Last updated Mar 25th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942599048 NPPES
North Dakota MEDICAID 81888

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