Healthcare Provider Details

I. General information

NPI: 1750357018
Provider Name (Legal Business Name): DENISE MARIE OLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 06/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 EAST CARVER ST DURHAM WOMENS CLINIC
DURHAM NC
27704
US

IV. Provider business mailing address

209 EAST CARVER ST
DURHAM NC
27704
US

V. Phone/Fax

Practice location:
  • Phone: 919-471-2273
  • Fax: 919-479-0881
Mailing address:
  • Phone: 919-471-2273
  • Fax: 919-479-0881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number9300266
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: