Olomon, Angela Suzzanne
Olomon, Angela Suzzanne is an sole proprietor health care provider with primary practice located at 900 E San Martin St , Bolivar MO 65613-2893. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Olomon, Angela Suzzanne can be contacted via phone (417) 326-7272.Contact Information
Primary practice address
900 E San Martin St
Bolivar MO 65613-2893
Phone: (417) 326-7272
Fax: (417) 326-2193
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | R1J41 | Missouri |
Profile Details
| NPI number | 1487618062 |
|---|---|
| LBN Legal business name | Olomon, Angela Suzzanne |
| Credentials | DO, FACN |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 12th, 2006 |
| Last updated | Jul 23rd, 2025 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487618062 | NPPES |
| Missouri | Other | MA3677001 | MEDICARE PTAN |
| Missouri | Other | P00230684 | MEDICARE PTAN |
| Missouri | MEDICAID | 242734010 | MEDICARE PTAN |
| Missouri | MEDICAID | 242734036 | MEDICARE PTAN |
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