Provider Demographics
NPI:1114187473
Name:OLOFSSON, BEATRIX ASTRID (MD)
Entity Type:Individual
Prefix:
First Name:BEATRIX
Middle Name:ASTRID
Last Name:OLOFSSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-4083
Mailing Address - Fax:717-812-2244
Practice Address - Street 1:35 MONUMENT RD
Practice Address - Street 2:SUITE 201
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5074
Practice Address - Country:US
Practice Address - Phone:717-812-4083
Practice Address - Fax:717-812-2244
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2662282085R0202X
PAMD4390232085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA788549OtherUPMC
PA102828983Medicaid
PA1621469OtherGATEWAY
PR30151053OtherAMERIHEALTH CARITAS - WMG
MD066793500Medicaid
PA2763516OtherHIGHMARK BLUE SHIELD
PA2763516OtherHIGHMARK BLUE SHIELD
PR30151053OtherAMERIHEALTH CARITAS - WMG