Individual
MARC A OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 E SILVER SPRING DR, WHITEFISH BAY, WI 53217-5222
(414) 247-4800
(414) 247-4801
Mailing address
3003 W GOOD HOPE ROAD, MILWAUKEE, WI 53209
(414) 352-3100
(414) 247-4590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21628
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30474500
—
WI
01
—
P00450900
RR MEDICARE
WI
Enumeration date
07/07/2006
Last updated
12/28/2010
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