Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | OH |
NPI | 1194721928 |
---|---|
Provider Name | Mrs. Margaret M Olsen |
First Address | Sylvania, OH 43560-9263 |
Second Address | Sylvania, OH 43560-9263 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0492131 | (05) | OH |
A15280 | (02) | OH |