Provider Demographics
NPI:1285899104
Name:PAUL OLSON, TERRAH J (MD)
Entity type:Individual
Prefix:
First Name:TERRAH
Middle Name:J
Last Name:PAUL OLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6335 HOSPITAL PARKWAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097
Mailing Address - Country:US
Mailing Address - Phone:404-778-3307
Mailing Address - Fax:770-813-4654
Practice Address - Street 1:6335 HOSPITAL PKWY STE 110
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1550
Practice Address - Country:US
Practice Address - Phone:404-778-3307
Practice Address - Fax:770-813-4654
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA078551208600000X
IL036.139651208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery