Basic Information
| Provider Information | |||||||||
| NPI: | 1093836843 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OLMSTEAD | ||||||||
| FirstName: | MATTHEW | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 1ST ST SW | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 559050001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7158385222 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 BELLINGER ST | ||||||||
| Address2: | |||||||||
| City: | EAU CLAIRE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 547035222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7158383635 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2007 | ||||||||
| LastUpdateDate: | 07/13/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 5101015633 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 50534 | WI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.