# DR. BAUER-OLSON, FAMILY DOCTOR, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588234066
- **Authorized official:** DR. CHERYL K BAUER-OLSON DO (OWNER)
- **Authorized official phone:** (701) 499-4847

## Contact information

- **Practice address:** 4133 30TH AVE S STE 103, FARGO, ND 58104-8421
- **Practice address phone:** (701) 499-4847
- **Practice address fax:** (701) 433-1882
- **Mailing address:** 2413 E COUNTRY CLUB DR S, FARGO, ND 58103-5730
- **Mailing address phone:** (701) 429-4385

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/28/2021
- **Last updated:** 05/15/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 14436 | — | ND |
| 05 | — | 1484174 | — | ND |
| 01 | — | 1588234066 | NDBS | ND |
| 05 | — | 1588234066 | — | MN |
| 01 | — | 4754236 | BCBSMN | MN |