Individual
MARK A OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11012 E 13 MILE RD, SUITE 112, WARREN, MI 48093-2572
(586) 573-6880
(586) 573-2562
Mailing address
29900 LORRAINE AVE, SUITE 400, WARREN, MI 48093-5266
(586) 582-0864
(586) 582-0964
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301044866
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1997933
—
MI
01
—
700E021830
BCBS
MI
01
—
700E021910
BCBS
MI
01
—
700F340300
BCBS
MI
01
—
MO044866
BCBS PIN #
MI
Enumeration date
08/19/2005
Last updated
11/08/2013
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