Olson, Derek
Olson, Derek is an individual health care provider with primary practice located at 4444 Kalamazoo Ave Se Ste 200 , Kentwood MI 49508. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Olson, Derek can be contacted via phone (616) 391-5600.Contact Information
Primary practice address
4444 Kalamazoo Ave Se Ste 200
Kentwood MI 49508
Phone: (616) 391-5600
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 5101014512 | Michigan |
Profile Details
| NPI number | 1770553901 |
|---|---|
| LBN Legal business name | Olson, Derek |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2006 |
| Last updated | Feb 25th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770553901 | NPPES |
| Illinois | MEDICAID | 036113363 |
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