Individual
DR. MARK WALTER OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1504 SAND POINT ROAD, MUNISING, MI 49862
(906) 387-4220
(906) 387-5449
Mailing address
1504 SAND POINT ROAD, MUNISING, MI 49862
(906) 387-4220
(906) 387-5449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301058238
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05670
MCLAREN HEALTH PLAN PIN
MI
01
—
0800217331
BLUECARE NETWORK PIN
MI
01
—
383165248101
MI COMMUNITY CHOICE PIN
MI
01
—
4301058238
STATE OF MI MEDICAL LICEN
MI
05
—
4840017
—
MI
01
—
MO058238
BLUE CROSS LICENSE
MI
01
—
QMXPR0017426
MOLINA HEALTHCARE PIN
MI
01
—
XX27082
HEALTH PLUS
MI
Enumeration date
06/15/2006
Last updated
03/07/2023
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