Mark K Olgaard, DO

Individual provider Active NPI Family Medicine Physician · Au Gres, MI

NPI 1811985658 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1811985658
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
5101008757 (MI)
Practice address
302 S Main St
Au Gres, MI 48703-8700
Phone
(989) 876-7104
Fax
(989) 876-2881
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150401002148 MI Order and Referring Only - Family Practice
Practitioner - Family Practice
6800081969

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101008757MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Tawas Past Accepting new patients
Mymichigan Medical Center Tawas Past Accepting new patients
Oscoda VA Outpatient Clinic Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101008757 MI Yes

Addresses

Primary practice location

302 S Main St
Au Gres, MI 48703-8700

Mailing address

PO Box 779
Tawas City, MI 48764-0779
Phone (989) 362-0153

Other identifiers

IdentifierTypeStateIssuer
3516709MedicaidMI

Other providers in Au Gres, MI

All providers in Au Gres, MI · Family Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.