Olson, Derek David

Olson, Derek David is an sole proprietor health care provider with primary practice located at 652 N Otsego Ave , Gaylord MI 49735-2502. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Olson, Derek David can be contacted via phone (989) 732-3529.

Contact Information

Primary practice address
652 N Otsego Ave Gaylord MI 49735-2502
Phone: (989) 732-3529
Fax: (989) 732-7865
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 4301076051 Michigan

Profile Details

NPI number 1497796007
LBN Legal business name Olson, Derek David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 8th, 2006
Last updated Jan 6th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497796007 NPPES
Michigan MEDICAID 4663576

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