Individual
ERIC A OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 266-1000
(260) 482-4442
Mailing address
3640 NEW VISION DR STE A, FORT WAYNE, IN 46845-1717
(260) 482-4440
(260) 482-4442
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01057913
IN
207P00000X
Emergency Medicine Physician
Primary
01061564A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000694195
ANTHEM
IN
05
—
200801860
—
IN
Enumeration date
07/19/2006
Last updated
04/23/2019
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