Individual
PERRY J OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
20400 W WARREN AVE, DETROIT, MI 48228-3242
(313) 271-0500
(313) 271-9319
Mailing address
23161 BRITNER CT, BINGHAM FARMS, MI 48025-4707
(248) 988-8227
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
364544473
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00219893
RAILROAD MEDICARE
MI
Enumeration date
07/21/2006
Last updated
01/08/2013
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