Provider Demographics
NPI:1316039605
Name:OLSON, KAREN (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 FLINTLOCK DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04021-4121
Mailing Address - Country:US
Mailing Address - Phone:207-829-6011
Mailing Address - Fax:207-829-6012
Practice Address - Street 1:42 FLINTLOCK DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:ME
Practice Address - Zip Code:04021-4121
Practice Address - Country:US
Practice Address - Phone:207-829-6011
Practice Address - Fax:207-829-6012
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0131162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME016626OtherANTHEM