Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 150 | SD |
N | 222Z00000X | Podiatrist | 150 | SD |
Y | 213E00000X | Podiatrist | 7 | ND |
Y | 222Z00000X | Podiatrist | 7 | ND |
NPI | 1033129002 |
---|---|
Provider Name | Aaron Carroll Olson |
First Address | Bismarck, ND 58501-4510 |
Second Address | Bismarck, ND 58501-4510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 18/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12125 | (05) | ND |
7760700 | (05) | SD |
CS1657 | RRMC (01) | |
T66960 | (02) |