Individual
JEREMY DAVID OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 241-8755
Mailing address
2829 UNIVERSITY AVE SE STE 730, MINNEAPOLIS, MN 55414-3279
(612) 439-1860
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
50312
MN
207P00000X
Emergency Medicine Physician
61335
WI
207P00000X
Emergency Medicine Physician
MD2009-0051
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19579
RESIDENT PERMIT
MN
Enumeration date
05/07/2008
Last updated
05/09/2022
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