Healthcare Provider Details

I. General information

NPI: 1043604986
Provider Name (Legal Business Name): CAITLIN P OLSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 LOTHROP ST STE 300
PITTSBURGH PA
15213-2548
US

IV. Provider business mailing address

3600 FORBES AVE PLAZA LEVEL STE 140
PITTSBURGH PA
15213-3410
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-2100
  • Fax:
Mailing address:
  • Phone: 480-707-7226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMT218583
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number125.067657
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA159753
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberP08307
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: