Individual
MIRA REGINA OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
360 BROADWAY STE 100, BANGOR, ME 04401-3900
(207) 907-3550
(207) 907-3562
Mailing address
360 BROADWAY STE 100, BANGOR, ME 04401-3979
(207) 907-3550
(207) 907-3562
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD18537
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1070564
—
LA
Enumeration date
06/15/2007
Last updated
05/25/2024
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