Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 036.148560 | IL |
Y | 207X00000X | Orthopaedic Surgeon | 282711 | MA |
N | 207X00000X | Orthopaedic Surgeon | MD463368 | PA |
NPI | 1003254822 |
---|---|
Provider Name | Dr. Adam Stephen Olsen |
First Address | Boston, MA 02115-6110 |
Second Address | Boston, MA 02115-6110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2013 |
Last Update Date | 01/09/2020 |