Healthcare Provider Details

I. General information

NPI: 1194721928
Provider Name (Legal Business Name): MARGARET M OLSEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7640 SYLVANIA AVE STE N
SYLVANIA OH
43560-9263
US

IV. Provider business mailing address

7640 SYLVANIA AVE STE N
SYLVANIA OH
43560-9263
US

V. Phone/Fax

Practice location:
  • Phone: 419-824-8371
  • Fax: 419-517-7576
Mailing address:
  • Phone: 419-824-8371
  • Fax: 419-517-7576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: