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CHARLES S OLSEN DO

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1821007451

Individual Registrant:
 CHARLES S OLSEN DO
Gender: M
Not Sole Proprietor

Location and contact information for practice:
128 MICHIGAN AVE  GLADSTONE, MI 49837-1929 US
Tel: 906-428-4084  Fax: 906-428-1881

Contact information for business:
128 MICHIGAN AVE  GLADSTONE, MI 49837-1929 US
Tel: 906-428-4084  Fax: 906-428-1881

Registration Information:
NPI: 1821007451
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
MI5101013811

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
RR MEDICARE GROUP#CC2139P00059355MI01
4549419MI05




HEALTH CARE JOBS MI - Page 1



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