MEDICARE: BRENDA F OLSON OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3533	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	410024988	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	W16042	OTHER	MA	BCBS
4	544140	OTHER		US HEALTHCARE
5	2200380	OTHER		UNITED HEALTH CARE
6	759369	OTHER		TUFTS
7	HARVARD PILGRIM	OTHER		151545
8	0538750001	OTHER	MA	DMERC

General Provider Information

NPI Number	:	1578551206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA F OLSON OD

Provider Business Mailing Address
First Line	:	27 FALMOUTH HEIGHTS RD
Second Line	:
City	:	FALMOUTH
State	:	MA
Zip	:	02540-3660
Country	:	US
Telephone Number	:	508-548-0505
Fax Number	:	508-548-0382

Provider Business Practice Location Address
First Line	:	27 FALMOUTH HEIGHTS RD
Second Line	:
City	:	FALMOUTH
State	:	MA
Zip	:	02540-3660
Country	:	US
Telephone Number	:	508-548-0505
Fax Number	:	508-548-0382

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	09/03/2013

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Directions to “ BRENDA F OLSON OD” Practice Location

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