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Individual

DOUGLAS J OLSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
SOUTHDALE RADIATION THERAPY CTR, 6401 FRANCE AVE S, EDINA, MN 55434
(952) 920-8477
(952) 920-5365
Mailing address
MPLS RADIATION ONCOLOGY, 6950 FRANCE AVE S #200, EDINA, MN 55435
(952) 920-4915
(952) 915-6091

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
24103
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
104834
UCARE
MN
01
105691
CHOICE PLUS
MN
05
12379
ND
01
12840OL
BLUE CROSS/BLUE SHIELD
MN
01
2400004
MEDICA PRIMARY
MN
01
2409880
MEDICA
MN
01
25135
AMERICA'S PPO
MN
05
30624000
WI
01
963070250002
PREFERRED ONE
MN
01
HP14103
HEALTH PARTNERS
MN
Enumeration date
08/19/2005
Last updated
07/08/2007
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