Provider Demographics
NPI:1992047468
Name:RADKEVICH-BROWN, OLGA SEMYONOVNA (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:OLGA
Middle Name:SEMYONOVNA
Last Name:RADKEVICH-BROWN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 BEN FRANKLIN HWY E
Mailing Address - Street 2:
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-8772
Mailing Address - Country:US
Mailing Address - Phone:610-288-2908
Mailing Address - Fax:610-898-4832
Practice Address - Street 1:200 MALL BLVD
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2902
Practice Address - Country:US
Practice Address - Phone:610-337-3195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2025-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD468442207N00000X
390200000X
IL036.143552207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program