Individual
PETER THOMAS OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
(218) 529-9120
Mailing address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
(218) 529-9120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54214
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356668222
BCBS OF MN
MN
05
—
1356668222
—
MN
01
—
P00978473
RR MEDICARE
—
Enumeration date
04/30/2010
Last updated
03/21/2012
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