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General NPI Number Information
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NPI Number | 1699736553
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Entity Type | Individual
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Provider Name | CHARLES E OLSON MD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2006
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 1120 N 103RD PLZ SUITE 100
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City | OMAHA
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State | NE
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Zip | 68114-1114
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Country | US
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Telephone | 402-391-5055
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Fax | 402-391-5053
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Provider Business Mailing Address
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Address Line | PO BOX 3755
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City | OMAHA
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State | NE
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Zip | 68103-0755
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Country | US
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Telephone | 402-354-2100
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Fax | 402-354-6171
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 18134
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 18134
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License Number State | NE
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