Healthcare Provider Details

I. General information

NPI: 1184365249
Provider Name (Legal Business Name): ERIKA RAE OLSEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

881 LEONARD FULGHUM DR STE 103
MOUNT PLEASANT SC
29464-5473
US

IV. Provider business mailing address

881 LEONARD FULGHUM DR STE 103
MOUNT PLEASANT SC
29464-5473
US

V. Phone/Fax

Practice location:
  • Phone: 843-884-5133
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number93589
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: