Provider Demographics
NPI:1194721928
Name:OLSEN, MARGARET M (MD)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:M
Last Name:OLSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7640 SYLVANIA AVE
Mailing Address - Street 2:STE N
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-9263
Mailing Address - Country:US
Mailing Address - Phone:419-824-8371
Mailing Address - Fax:419-517-7576
Practice Address - Street 1:7640 SYLVANIA AVE
Practice Address - Street 2:STE N
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-9263
Practice Address - Country:US
Practice Address - Phone:419-824-8371
Practice Address - Fax:419-517-7576
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0492131Medicaid
OHOL7251761Medicare ID - Type Unspecified
OH0492131Medicaid