Olsen, Benjy

Olsen, Benjy is an individual health care provider with primary practice located at 1027 Washington Ave , Detroit Lakes MN 56501-3409. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Olsen, Benjy can be contacted via phone (188) 475-6112.

Contact Information

Primary practice address
1027 Washington Ave Detroit Lakes MN 56501-3409
Phone: (188) 475-6112
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 187 South Dakota
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 00764 Iowa
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 770 Minnesota
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 770 Minnesota

Profile Details

NPI number 1205889417
LBN Legal business name Olsen, Benjy
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Oct 4th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205889417 NPPES
South Dakota MEDICAID 6800722
South Dakota MEDICAID 0293209

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