Individual
KENNETH DAVID OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 863-4000
(763) 236-3026
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37478
MN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
1033179429
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
409525100
—
MN
Enumeration date
03/28/2006
Last updated
11/10/2020
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