Individual
MICAH L OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1920 E CAMBRIDGE AVE STE 301, PHOENIX, AZ 85006-1464
(602) 933-0935
(602) 933-2471
Mailing address
3200 E CAMELBACK RD STE 250, PHOENIX, AZ 85018-2327
(602) 933-1814
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35470
AZ
2080P0205X
Pediatric Endocrinology Physician
Primary
35470
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122062
—
AZ
Enumeration date
07/10/2006
Last updated
03/26/2018
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