Provider Demographics
NPI:1629018783
Name:OLSON, KRISTA KUGAJEVSKY (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:KUGAJEVSKY
Last Name:OLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:
Other - Last Name:KUGAJEVSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:575 COPELAND MILL RD
Mailing Address - Street 2:SUITE #1D
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8977
Mailing Address - Country:US
Mailing Address - Phone:614-794-0481
Mailing Address - Fax:614-794-3711
Practice Address - Street 1:500 S CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8971
Practice Address - Country:US
Practice Address - Phone:614-794-0481
Practice Address - Fax:614-794-3711
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.080794207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH61443Medicare UPIN