Individual
RICHARD K OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2743161205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107008142101
IHC HEALTHPLANS
UT
01
—
110116385
PALMETTO GBA
UT
01
—
220734
DMBA
UT
01
—
35882
PEHP
UT
01
—
QMAF03080
ALTIUS
UT
Enumeration date
05/04/2006
Last updated
11/27/2023
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